Background: Burkitt lymphoma is a rare, aggressive B-cell neoplasm with frequent central nervous system (CNS) involvement, treated with intensive multidrug regimens associated with rituximab. The aim of this study was to assess the efficacy, safety, and feasibility of the LMB protocol in adults with BL in a real-world setting.Methods: We included 55 patients with BL diagnosis according to the 2008 WHO classification, treated with LMB protocol associated with rituximab. Low-risk patients (no bone marrow or CNS involvement) were treated in the group B arm, while high-risk patients were placed in group C, which was further stratified by age and CNS infiltration.Results: Thirty-four patients (62%) were treated in group B and 21 patients (38%) were treated in group C, with a median age of 34 years (16–77). Extranodal infiltration was present in 71% patients, including 11 (20%) with CNS involvement. After a median follow up time of 7 years, the complete remission rate was 85%, and progression-free and overall survival at 3 years were 79% and 84%, respectively. Patients with CNS infiltration had an inferior survival rate (55% at 3 years). Grade 3–4 toxicities were frequent, mainly hematologic, infectious, and mucosal. Treatment required substantial supportive care, including 1604 transfusions and 4696 days of hospitalization. Patients over 60 years had poorer outcomes and higher toxicity.Conclusions: The LMB protocol demonstrated high survival rates in adult BL, although at the cost of significant toxicity and considerable health care resource utilization. Outcomes remained suboptimal in patients with CNS involvement despite treatment intensification.
背景：伯基特淋巴瘤是一种罕见且侵袭性强的B细胞肿瘤，常累及中枢神经系统，通常采用含利妥昔单抗的强化多药方案进行治疗。本研究旨在评估LMB方案在真实世界成人伯基特淋巴瘤患者中的疗效、安全性及可行性。 方法：根据2008年WHO分类标准，我们纳入了55例经LMB方案联合利妥昔单抗治疗的伯基特淋巴瘤患者。低危患者（无骨髓或中枢神经系统受累）接受B组方案治疗，高危患者则纳入C组，并根据年龄及中枢神经系统浸润情况进行进一步分层。 结果：34例患者（62%）接受B组方案治疗，21例患者（38%）接受C组方案治疗，中位年龄为34岁（范围16-77岁）。71%的患者存在结外浸润，其中11例（20%）伴有中枢神经系统受累。中位随访7年后，完全缓解率为85%，3年无进展生存率和总生存率分别为79%和84%。中枢神经系统浸润患者的生存率较低（3年生存率为55%）。3-4级毒性反应较为常见，主要为血液学毒性、感染及黏膜炎。治疗需要大量支持性护理，包括1604次输血和4696天的住院治疗。60岁以上患者预后较差且毒性反应更高。 结论：LMB方案在成人伯基特淋巴瘤中显示出较高的生存率，但代价是显著的毒性和大量的医疗资源消耗。尽管进行了强化治疗，中枢神经系统受累患者的预后仍不理想。
肿瘤(癌症)患者之家