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Type: Artigo
Title: Outcomes of HIV-associated Burkitt Lymphoma in Brazil: high treatment toxicity and refractoriness rates – a multicenter cohort study
Author: Silva, W.F.D.
Garibaldi, P.M.M.
Rosa, L.I.D.
Bellesso, M.
Clé, D.V.
Delamain, M.T.
Rego, E.M.
Pereira, J.
Rocha, V.
Abstract: Although the increased use of combined antiretroviral therapy (cART) has decreased the incidence of lymphomas HIV-associated, Burkitt lymphoma (BL) incidence remains stable. Reported outcomes on HIV-associated BL from developed countries seem to corroborate that the regimens do not need to be tailored to the HIV-positive population. Materials and methods: This is a retrospective multicenter cohort study from Brazil, including HIV-positive patients aged 15 years and above diagnosed with BL. Results: A total of 54 patients were included. Median age was 39 years (range, 15–64). At diagnosis, advanced disease was found in 86% and 52% had a CD4+ count lower than 200 cells/mm3. Five patients died before starting any regimen. Among the remaining 49 patients, most were treated with Hyper-CVAD (53%) and CODOX-M IVAC (18%). Rituximab was used in frontline in only 16% of the patients. Primary refractory disease was found in 14%. A treatment-related mortality of 38.7% and a complete response rate of 44.9% were found. At 4 years, estimated overall survival (OS) was 39.8%. All relapsed and primary refractory patients eventually died. Remaining patients died from infections (24/34), despite antimicrobial prophylaxis and associated cART. Conclusion: Early mortality and toxicity were higher in our cohort than in developed countries. A faster diagnosis, better understanding of the biology of the disease, establishment of low toxicity regimens, inclusion of rituximab and improvement of supportive care may decrease the mortality of HIV-associated BL in developing countries
Subject: Quimioterapia
Country: Reino Unido
Editor: Elsevier
Rights: Fechado
Identifier DOI: 10.1016/j.leukres.2019.106287
Date Issue: 2020
Appears in Collections:FCM - Artigos e Outros Documentos

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