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Burns EA, Wilson JJ, Mathur S, Kieser R, Gong Z, Hu CCA, Tang CHA, Petkova J, Yuen C, Mai H, Shah S, Rice L, Ganguly S, Pingali SR. Long-term outcomes in patients with Burkitt lymphoma older than 65 years: an analysis of the Texas Cancer Registry. Ann Hematol 2023; 102:2753-2763. [PMID: 37422592 DOI: 10.1007/s00277-023-05328-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/19/2023] [Indexed: 07/10/2023]
Abstract
Burkitt lymphoma (BL) is an extremely aggressive but curable subtype of non-Hodgkin lymphoma. While younger patients have excellent outcomes in response to aggressive chemoimmunotherapy, the rarity of this disease in older patients and limitations caused by age, comorbidities, and performance status may negate survival advantages. This analysis assessed outcomes of older adults with BL through data provided by the Texas Cancer Registry (TCR). Patients ≥65 years with BL were assessed. Patients were dichotomized into 1997-2007 and 2008-2018. Median overall survival (OS) and disease-specific survival (DSS) were assessed using Kaplan-Meier methodology, and covariates including age, race, sex, stage, primary site, and poverty index were analyzed using Pearson Chi-squared analysis. Odds ratio (OR) with 95% confidence intervals (CI) was used to assess factors contributing to patients not offered systemic therapy. P value <0.05 was considered statistically significant. Non-BL mortality events were also categorized. There were 325 adults, 167 in 1997-2007 and 158 in 2008-2018; 106 (63.5%) and 121 (76.6%) received systemic therapy, a trend that increased with time (p = 0.010). Median OS for 1997-2007 and 2008-2018 was 5 months (95% CI 2.469, 7.531) and 9 months (95% CI 0.000, 19.154) (p = 0.013), and DSS was 72 months (95% CI 56.397, 87.603) (p = 0.604) and not reached, respectively. For patients that received systemic therapy, median OS was 8 months (95% CI 1.278, 14.722) and 26 months (95% CI 5.824, 46.176) (p = 0.072), respectively, and DSS was 79 months (95% CI: 56.416, 101.584) and not reached, respectively (p = 0.607). Age ≥75 years (HR 1.39 [95% CI 1.078, 1.791], p = 0.011) and non-Hispanic whites (HR 1.407 [95% CI 1.024, 1.935], p = 0.035) had poorer outcomes, and patients at the 20-100% poverty index (OR 0.387 [95% CI 0.163, 0.921], p = 0.032) and increasing age at diagnosis (OR 0.947 [95% CI 0.913, 0.983], p = 0.004) were less likely to receive systemic therapy. Of 259 (79.7%) deaths, 62 (23.9%) were non-BL deaths, and 6 (9.6%) of these were from a second cancer. This two-decade analysis of older Texas patients with BL indicates a significant improvement in OS over time. Although patients were more likely to receive systemic therapy over time, treatment disparities existed in patients residing in poverty-stricken regions of Texas and in advancing age. These statewide findings reflect an unmet national need to find a systemic therapeutic strategy that can be tolerated by and augment outcomes in the growing elderly population.
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Affiliation(s)
- Ethan A Burns
- Neal Cancer Center, Houston Methodist Hospital, 6445 Main Street, Outpatient Center, 24th Floor., Houston, TX, 77030, USA
| | - Justin J Wilson
- Trinity School of Medicine, 925 Woodstock Road, Ste 200, GA, Roswell, USA
| | - Sunil Mathur
- Neal Cancer Center, Houston Methodist Hospital, 6445 Main Street, Outpatient Center, 24th Floor., Houston, TX, 77030, USA
| | - Ryan Kieser
- Neal Cancer Center, Houston Methodist Hospital, 6445 Main Street, Outpatient Center, 24th Floor., Houston, TX, 77030, USA
| | - Zimu Gong
- Neal Cancer Center, Houston Methodist Hospital, 6445 Main Street, Outpatient Center, 24th Floor., Houston, TX, 77030, USA
| | - Chih-Chi Andrew Hu
- Center for Translational Research in Hematologic Malignancies, Neal Cancer Center, Houston Methodist Research Institute, 6550 Fannin St, Houston, TX, 77030, USA
| | - Chih-Hang Anthony Tang
- Center for Translational Research in Hematologic Malignancies, Neal Cancer Center, Houston Methodist Research Institute, 6550 Fannin St, Houston, TX, 77030, USA
| | - Jenny Petkova
- Department of Academic Medicine, Houston Methodist Hospital, 6550 Fannin St Ste. 1001, Houston, TX, 77030, USA
| | - Carrie Yuen
- Neal Cancer Center, Houston Methodist Hospital, 6445 Main Street, Outpatient Center, 24th Floor., Houston, TX, 77030, USA
| | - Hanh Mai
- Neal Cancer Center, Houston Methodist Hospital, 6445 Main Street, Outpatient Center, 24th Floor., Houston, TX, 77030, USA
| | - Shilpan Shah
- Neal Cancer Center, Houston Methodist Hospital, 6445 Main Street, Outpatient Center, 24th Floor., Houston, TX, 77030, USA
| | - Lawrence Rice
- Neal Cancer Center, Houston Methodist Hospital, 6445 Main Street, Outpatient Center, 24th Floor., Houston, TX, 77030, USA
- Department of Academic Medicine, Houston Methodist Hospital, 6550 Fannin St Ste. 1001, Houston, TX, 77030, USA
| | - Siddhartha Ganguly
- Neal Cancer Center, Houston Methodist Hospital, 6445 Main Street, Outpatient Center, 24th Floor., Houston, TX, 77030, USA
| | - Sai Ravi Pingali
- Neal Cancer Center, Houston Methodist Hospital, 6445 Main Street, Outpatient Center, 24th Floor., Houston, TX, 77030, USA.
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Wang K, Wei J, Ma J, Jia Q, Liu Y, Chai J, Xu J, Xu T, Zhao D, Wang Y, Yan Q, Guo S, Guo X, Zhu F, Fan L, Li M, Wang Z. Phosphorylation of PBK/TOPK Tyr74 by JAK2 promotes Burkitt lymphoma tumor growth. Cancer Lett 2022; 544:215812. [PMID: 35780928 DOI: 10.1016/j.canlet.2022.215812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/08/2022] [Accepted: 06/27/2022] [Indexed: 11/02/2022]
Abstract
Burkitt lymphoma (BL), which is characterized by high invasiveness, is a subgroup of non-Hodgkin lymphoma. Although BL is regarded as a highly curable disease, especially for children, some patients unfortunately still do not respond adequately. The understanding of the etiology and molecular mechanisms of BL is still limited, and targeted therapies are still lacking. Here, we found that T-LAK cell-derived protein kinase (TOPK) and phosphorylated Janus kinase 2 (p-JAK2) are highly expressed in the tissues of BL patients. We report that TOPK directly binds to and is phosphorylated at Tyr74 by JAK2. Histone H3, one of the downstream targets of TOPK, is also phosphorylated in vivo and in vitro. Furthermore, we report that the phosphorylation of TOPK at Tyr74 by JAK2 plays a vital role in the proliferation of BL cells and promotes BL tumorigenesis in vivo. Phosphorylation of TOPK at Tyr74 by JAK2 enhances the stability of TOPK. Collectively, our results suggest that the JAK2/TOPK/histone H3 axis plays a key role in the proliferation of BL cells and BL tumorigenesis in vivo.
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Affiliation(s)
- Kaijing Wang
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Air Force Medical University, Xi'an, China
| | - Jie Wei
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Air Force Medical University, Xi'an, China
| | - Jing Ma
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Air Force Medical University, Xi'an, China
| | - Qingge Jia
- Department of Reproductive Endocrinology, Xi'an International Medical Center Hospital, Northwest University, Xi'an, China
| | - Yixiong Liu
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Air Force Medical University, Xi'an, China
| | - Jia Chai
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Air Force Medical University, Xi'an, China
| | - Junpeng Xu
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Air Force Medical University, Xi'an, China
| | - Tianqi Xu
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Air Force Medical University, Xi'an, China
| | - Danhui Zhao
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Air Force Medical University, Xi'an, China
| | - Yingmei Wang
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Air Force Medical University, Xi'an, China
| | - Qingguo Yan
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Air Force Medical University, Xi'an, China
| | - Shuangping Guo
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Air Force Medical University, Xi'an, China
| | - Xinjian Guo
- Department of Pathology, Affiliated Hospital of Qinghai University, Xining City, Qinghai Province, China
| | - Feng Zhu
- Cancer Research Institute, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Linni Fan
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Air Force Medical University, Xi'an, China.
| | - Mingyang Li
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Air Force Medical University, Xi'an, China.
| | - Zhe Wang
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Air Force Medical University, Xi'an, China.
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Improved survival of Burkitt lymphoma/leukemia patients: observations from Poland, 1999-2020. Ann Hematol 2022; 101:1059-1065. [PMID: 35293608 DOI: 10.1007/s00277-022-04758-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/10/2022] [Indexed: 11/01/2022]
Abstract
The aim of this study was to estimate the survival of Polish Burkitt lymphoma/leukemia (BL) patients diagnosed between 1999 and 2017, considering multiple covariates and periods, to reflect changes in BL treatment. We identified all BL patients registered in the Polish National Cancer Registry in 1999-2017. Observed survival (OS) was evaluated deploying the life table method. Univariate and multivariate Cox proportional hazards regression models were fit to generate hazard ratios (HR) and the corresponding 95% confidence intervals (95% CI), describing the association between exposures (sex, age at the diagnosis, year of diagnosis, and region of residence) and time-to-event (death). Two-sided log-rank test was applied to assess the significance of exposures. Overall, 937 BL cases were included in the study (654 men and 283 women). Between the periods 1999-2005 and 2015-2017, the 3-year OS changed from 56.0% (95% CI 50.4 to 62.2%) to 73.8% (68.1 to 80.0%; P < 0.001), and the 5-year OS increased from 53.8% (48.2 to 60.0%) to 73.0% (67.1 to 79.3%; P < 0.001). The death HR was significantly higher in adolescents and young adults' (AYA) and adults' groups than in pediatric patients (HR = 3.00, 95% CI 2.05 to 4.39, P < 0.001, for AYA; and HR = 7.30, 5.14 to 10.3, P < 0.001, for adults). During the last two decades, the survival of Polish BL patients has been systematically improving. The death hazard ratio is most significantly associated with the patients' age at diagnosis and year of diagnosis, and not associated with sex or region of residence.
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Lei Y, Huang Q, Li X, Zheng X, Liu M. Characteristics and survival outcomes of primary splenic cancers: A SEER population-based study. Medicine (Baltimore) 2022; 101:e28539. [PMID: 35060511 PMCID: PMC8772628 DOI: 10.1097/md.0000000000028539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/20/2021] [Indexed: 02/05/2023] Open
Abstract
Primary splenic cancers represent a small number of cancer cases and studies on its clinicopathological features and outcomes are limited. Splenic lymphomas and primary splenic angiosarcoma (PSA) are the 2 most common histological types of splenic cancers. This population-based study aimed to investigate the clinical characteristics and survival outcomes of patients with splenic lymphomas or PSA.Patients diagnosed with splenic lymphomas or PSA between 2000 and 2015 were identified from the Surveillance Epidemiology and End Results database of the National Cancer Institutes. Overall survival (OS) and cancer-specific survival (CSS) rates were calculated using the Kaplan-Meier method. A Cox proportional hazard models were used to identify independent predictors of cancer-specific mortality.A total of 700 patients with splenic lymphoma and 48 patients with PSA were included in this study. The median age of patients with splenic lymphoma was 65 years and 57 years for patients with PSA. For patients with splenic lymphoma, the most prevalent histological subtypes were splenic marginal zone lymphoma and diffuse large B-cell lymphoma. A total of 52.6% of the cases had stage IV disease based on the Ann Arbor staging system. Five-year OS and CSS were 76.9% and 83.4%, respectively. Multivariate analysis revealed that independent predictors of splenic lymphoma CSS included race, stage, chemotherapy, and histological subtype. However, a much shorter OS time was seen in the PSA cohort which had a 5-year OS of 11.8%, a median OS of 10.0 months and the 5-year CSS of 12.4%. Chemotherapy was correlated with better outcomes in patients with PSA. However, the survival benefits of surgery for splenic cancer were not statistically significant in our study.The current study is the largest cohort of primary splenic cancer presented in literature based on the Surveillance Epidemiology and End Results database and our large series describe the characteristics and survival outcomes of such rare diseases which may provide reliable information for further studies and clinicians.
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Pereira RF, Mauro GP, Medici CTM, Casimiro LC, Weltman E. Radiotherapy in Adult Burkitt Lymphoma: A Retrospective Analysis in a Large University Center. Indian J Hematol Blood Transfus 2021; 38:508-515. [DOI: 10.1007/s12288-021-01495-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 09/30/2021] [Indexed: 10/20/2022] Open
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Della Rocca AM, Tonin FS, Fachi MM, Cobre AF, Ferreira VL, Leonart LP, Steffenello-Durigon G, Del Moral JAG, Lenzi L, Pontarolo R. Prognostic Factors, Survival Analyses and the Risk of Second Primary Cancer: A Population-Based Study on Burkitt Lymphoma/Leukemia. Diseases 2021; 9:diseases9020043. [PMID: 34203748 PMCID: PMC8293230 DOI: 10.3390/diseases9020043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/03/2021] [Accepted: 06/12/2021] [Indexed: 11/16/2022] Open
Abstract
Burkitt lymphoma/leukemia (BL/L) is an aggressive oncohematological disease. This study evaluated the population-based prognosis and survival on BL/L as well as if BL/L behaved as a risk factor for the development of second primary cancers (SPCs) and if other first tumors behaved as risk factors for the occurrence of BL/L as an SPC. A retrospective cohort using the Surveillance, Epidemiology and End Results (SEER) Program (2008–2016) was performed. Kaplan–Meier, time-dependent covariate Cox regression and Poisson regression models were conducted. Overall, 3094 patients were included (median, 45 years; IQR, 22–62). The estimated overall survival was 65.4 months (95% CI, 63.6–67.3). Significantly more deaths occurred for older patients, black race, disease at an advanced stage, patients without chemotherapy/surgery and patients who underwent radiotherapy. Hodgkin lymphomas (nodal) (RR, 7.6 (3.9–15.0; p < 0.001)), Kaposi sarcomas (34.0 (16.8–68.9; p < 0.001)), liver tumors (3.4 (1.2–9.3; p = 0.020)) and trachea, mediastinum and other respiratory cancers (15.8 (2.2–113.9; p = 0.006)) behaved as risk factors for the occurrence of BL/L as an SPC. BL/L was a risk factor for the occurrence of SPCs as acute myeloid leukemias (4.6 (2.1–10.4; p < 0.001)), Hodgkin lymphomas (extranodal) (74.3 (10.0–549.8; p < 0.001)) and Kaposi sarcomas (35.1 (12.1–101.4; p < 0.001)). These results may assist the development of diagnostic and clinical recommendations for BL/L.
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Affiliation(s)
- Ana M. Della Rocca
- Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba 80210-170, PR, Brazil; (A.M.D.R.); (F.S.T.); (M.M.F.); (A.F.C.); (V.L.F.); (L.P.L.)
| | - Fernanda S. Tonin
- Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba 80210-170, PR, Brazil; (A.M.D.R.); (F.S.T.); (M.M.F.); (A.F.C.); (V.L.F.); (L.P.L.)
| | - Mariana M. Fachi
- Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba 80210-170, PR, Brazil; (A.M.D.R.); (F.S.T.); (M.M.F.); (A.F.C.); (V.L.F.); (L.P.L.)
| | - Alexandre F. Cobre
- Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba 80210-170, PR, Brazil; (A.M.D.R.); (F.S.T.); (M.M.F.); (A.F.C.); (V.L.F.); (L.P.L.)
| | - Vinicius L. Ferreira
- Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba 80210-170, PR, Brazil; (A.M.D.R.); (F.S.T.); (M.M.F.); (A.F.C.); (V.L.F.); (L.P.L.)
| | - Letícia P. Leonart
- Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba 80210-170, PR, Brazil; (A.M.D.R.); (F.S.T.); (M.M.F.); (A.F.C.); (V.L.F.); (L.P.L.)
| | - Giovanna Steffenello-Durigon
- Hematology Service, University Hospital Professor Polydoro Ernani de São Thiago, Federal University of Santa Catarina, Florianópolis 88036-800, SC, Brazil; (G.S.-D.); (J.A.G.D.M.)
| | - Joanita A. G. Del Moral
- Hematology Service, University Hospital Professor Polydoro Ernani de São Thiago, Federal University of Santa Catarina, Florianópolis 88036-800, SC, Brazil; (G.S.-D.); (J.A.G.D.M.)
| | - Luana Lenzi
- Department of Clinical Analyses, Federal University of Paraná, Curitiba 80210-170, PR, Brazil;
| | - Roberto Pontarolo
- Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba 80210-170, PR, Brazil; (A.M.D.R.); (F.S.T.); (M.M.F.); (A.F.C.); (V.L.F.); (L.P.L.)
- Department of Pharmacy, Federal University of Paraná, Curitiba 80210-170, PR, Brazil
- Correspondence: ; Tel.: +55-41-3360-4076
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Wang N, Zeng GZ, Yin JL, Bian ZX. Artesunate activates the ATF4-CHOP-CHAC1 pathway and affects ferroptosis in Burkitt's Lymphoma. Biochem Biophys Res Commun 2019; 519:533-539. [PMID: 31537387 DOI: 10.1016/j.bbrc.2019.09.023] [Citation(s) in RCA: 121] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 09/07/2019] [Indexed: 01/06/2023]
Abstract
Currently, there is no effective treatment for Burkitt's lymphoma in patients aged above 60 years, and thus research on effective treatment options for Burkitt's lymphoma has been gaining increasing attention. Artesunate has been identified as a novel effective growth suppressor in Burkitt's lymphoma. Here, we utilized molecular biology, transcriptome analysis, and other techniques to study artesunate-induced death of the Burkitt's lymphoma cells DAUDI and CA-46, the effect of artesunate on gene expression in DAUDI and CA-46 cells, and the effect of artesunate-induced ATF4-CHOP-CHAC1 pathway on ferroptosis. We also studied the inhibitory effects and ferroptosis induction of artesunate on CA-46 cells in mouse xenografts. Results showed that artesunate induced ferroptosis in DAUDI and CA-46 cells, as evidenced by the protective effect of liproxstatin-1, ferrostatin-1, and desferoxamine, resulting in an endoplasmic reticulum stress response, activation of the ATF4-CHOP-CHAC1 pathway enhanced ferroptosis in DAUDI and CA-46 cells. A mouse-transplanted tumor model showed that artesunate can inhibit the proliferation and induce ferroptosis of CA-46 cells in vivo. This study provides a novel perspective for the development of drugs against different types of Burkitt's lymphomas.
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Affiliation(s)
- Ning Wang
- Key Laboratory of Chemistry in Ethnic Medicinal Resources, State Ethnic Affairs Commission and Ministry of Education, Yunnan Minzu University, Kunming, Yunnan, China
| | - Guang-Zhi Zeng
- Key Laboratory of Chemistry in Ethnic Medicinal Resources, State Ethnic Affairs Commission and Ministry of Education, Yunnan Minzu University, Kunming, Yunnan, China
| | - Jun-Lin Yin
- Key Laboratory of Chemistry in Ethnic Medicinal Resources, State Ethnic Affairs Commission and Ministry of Education, Yunnan Minzu University, Kunming, Yunnan, China.
| | - Zhao-Xiang Bian
- Lab of Brain and Gut Research, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China.
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Liu ZL, Liu PP, Bi XW, Lei DX, Wang Y, Li ZM, Jiang WQ, Xia Y. Trends in survival of patients with stage I/II Burkitt lymphoma in the United States: A SEER database analysis. Cancer Med 2019; 8:874-881. [PMID: 30706675 PMCID: PMC6434224 DOI: 10.1002/cam4.1870] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/15/2018] [Accepted: 10/22/2018] [Indexed: 11/16/2022] Open
Abstract
The treatment strategy for management of Burkitt lymphoma (BL) has evolved during the past decades and the clinical outcome for this disease as a whole has also improved. Due to limited information reported on survival trends of patients with stage I/II (limited‐stage) BL, here we used the Surveillance, Epidemiology, and End Results (SEER) database to conduct our study. The time period was divided into two eras (1983‐2001 and 2002‐2014) as the recent era reflected more intensive chemotherapy regimens, the availability of rituximab, the widespread use of antiretroviral therapy (ART) and improvements in supportive care. Patients with limited‐stage BL had a significantly better 5‐year overall survival (OS) in the 2002‐2014 era in both univariate analysis and multivariate analysis, compared with those in the 1983‐2001 era (64.1% vs 57.4%). However, clinical outcomes of elderly patients (≥60 years) and children patients (0‐19 years) did not significantly improve. Older age and race of black were correlated with poorer OS in multivariate analysis, whereas sex, primary sites, and application of radiotherapy did not significantly influence OS. In conclusion, the prognosis of patients with limited‐stage BL has improved in the 2002‐2014 era, but the outcome was still much poorer in elderly patients, which needs to be improved by identifying newly molecular‐targeted drugs and developing novel personalized therapeutic approaches.
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Affiliation(s)
- Ze-Long Liu
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Pan-Pan Liu
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Xi-Wen Bi
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - De-Xin Lei
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Yu Wang
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Zhi-Ming Li
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Wen-Qi Jiang
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Yi Xia
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
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