Burkitt Lymphoma International Prognostic Index. Issue 10 (1st April 2021)

• Record Type: Journal Article
• Authors: Olszewski, Adam J.; Jakobsen, Lasse H.; Collins, Graham P.; Cwynarski, Kate; Bachanova, Veronika; Blum, Kristie A.; Boughan, Kirsten M.; Bower, Mark; Dalla Pria, Alessia; Danilov, Alexey; David, Kevin A.; Diefenbach, Catherine; Ellin, Fredrik; Epperla, Narendranath; Farooq, Umar; Feldman, Tatyana A.; Gerrie, Alina S.; Jagadeesh, Deepa; Kamdar, Manali; Karmali, Reem; Kassam, Shireen; Kenkre, Vaishalee P.; Khan, Nadia; Kim, Seo-Hyun; Klein, Andreas K.; Lossos, Izidore S.; Lunning, Matthew A.; Martin, Peter; Martinez-Calle, Nicolas; Montoto, Silvia; Naik, Seema; Palmisiano, Neil; Peace, David; Phillips, Elizabeth H.; Phillips, Tycel J.; Portell, Craig A.; Reddy, Nishitha; Santarsieri, Anna; Sarraf Yazdy, Maryam; Smeland, Knut B.; Smith, Scott E.; Smith, Stephen D.; Sundaram, Suchitra; Zayac, Adam S.; Zhang, Xiao-Yin; Zhu, Catherine; Cheah, Chan Y.; El-Galaly, Tarec C.; Evens, Andrew M.;
• Is Part Of: Journal of clinical oncology. Volume 39:Issue 10(2021)
• Page Start: 1129
• Page End: 1138
• Publication Date: 2021-04-01
• Subjects: Oncology -- Periodicals; Cancer -- Periodicals; Oncology; Medical Oncology; Cancérologie -- Périodiques; Cancer -- Périodiques; Cancérologie; Cancer; Oncology; Oncologia; Càncer; Periodicals; 616.994
• DOI: 10.1200/JCO.20.03288
• Languages: English
• ISSNs: 0732-183X

Abstract

Abstract : PURPOSE: Burkitt 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. METHODS: We 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. RESULTS: In 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. CONCLUSION: The 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.