Burkitt Lymphoma International Prognostic Index.

Research output: Contribution to journalArticlepeer-review

Abstract

PurposeBurkitt lymphoma (BL) has unique biology and clinical course but lacks a standardized prognostic model. We developed and validated a novel prognostic index specific for BL to aid risk stratification, interpretation of clinical trials, and targeted development of novel treatment approaches.MethodsWe derived the BL International Prognostic Index (BL-IPI) from a real-world data set of adult patients with BL treated with immunochemotherapy in the United States between 2009 and 2018, identifying candidate variables that showed the strongest prognostic association with progression-free survival (PFS). The index was validated in an external data set of patients treated in Europe, Canada, and Australia between 2004 and 2019.ResultsIn the derivation cohort of 633 patients with BL, age ≥ 40 years, performance status ≥ 2, serum lactate dehydrogenase > 3× upper limit of normal, and CNS involvement were selected as equally weighted factors with an independent prognostic value. The resulting BL-IPI identified groups with low (zero risk factors, 18% of patients), intermediate (one factor, 36% of patients), and high risk (≥ 2 factors, 46% of patients) with 3-year PFS estimates of 92%, 72%, and 53%, respectively, and 3-year overall survival estimates of 96%, 76%, and 59%, respectively. The index discriminated outcomes regardless of HIV status, stage, or first-line chemotherapy regimen. Patient characteristics, relative size of the BL-IPI groupings, and outcome discrimination were consistent in the validation cohort of 457 patients, with 3-year PFS estimates of 96%, 82%, and 63% for low-, intermediate-, and high-risk BL-IPI, respectively.ConclusionThe BL-IPI provides robust discrimination of survival in adult BL, suitable for use as prognostication and stratification in trials. The high-risk group has suboptimal outcomes with standard therapy and should be considered for innovative treatment approaches.
Original languageEnglish
Pages (from-to)1129-1138
Number of pages10
JournalJournal of clinical oncology : official journal of the American Society of Clinical Oncology
Volume39
Issue number10
DOIs
Publication statusPublished - 27 Jan 2021

Keywords

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols/therapeutic use
  • Australia
  • Burkitt Lymphoma/drug therapy
  • Canada
  • Cohort Studies
  • Europe
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Outcome Assessment, Health Care/methods
  • Prognosis
  • Rituximab/administration & dosage
  • United States

Research Beacons, Institutes and Platforms

  • Manchester Cancer Research Centre

Fingerprint

Dive into the research topics of 'Burkitt Lymphoma International Prognostic Index.'. Together they form a unique fingerprint.

Cite this