Burkitt Lymphoma International Prognostic Index
(2021) In Journal of clinical oncology : official journal of the American Society of Clinical Oncology 39(10). p.1129-1138- 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.... (More)
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.
(Less)
- author
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- volume
- 39
- issue
- 10
- pages
- 10 pages
- publisher
- American Society of Clinical Oncology
- external identifiers
-
- scopus:85103683383
- pmid:33502927
- ISSN
- 0732-183X
- DOI
- 10.1200/JCO.20.03288
- language
- English
- LU publication?
- yes
- id
- 253268fe-3739-4ded-92c9-a425c507d2ae
- date added to LUP
- 2021-04-12 11:31:35
- date last changed
- 2024-08-10 14:31:14
@article{253268fe-3739-4ded-92c9-a425c507d2ae,
abstract = {{<p>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.</p>}},
author = {{Olszewski, Adam J. and Jakobsen, Lasse H. and Collins, Graham P. and Cwynarski, Kate and Bachanova, Veronika and Blum, Kristie A. and Boughan, Kirsten M. and Bower, Mark and Dalla Pria, Alessia and Danilov, Alexey and David, Kevin A. and Diefenbach, Catherine and Ellin, Fredrik and Epperla, Narendranath and Farooq, Umar and Feldman, Tatyana A. and Gerrie, Alina S. and Jagadeesh, Deepa and Kamdar, Manali and Karmali, Reem and Kassam, Shireen and Kenkre, Vaishalee P. and Khan, Nadia and Kim, Seo Hyun and Klein, Andreas K. and Lossos, Izidore S. and Lunning, Matthew A. and Martin, Peter and Martinez-Calle, Nicolas and Montoto, Silvia and Naik, Seema and Palmisiano, Neil and Peace, David and Phillips, Elizabeth H. and Phillips, Tycel J. and Portell, Craig A. and Reddy, Nishitha and Santarsieri, Anna and Sarraf Yazdy, Maryam and Smeland, Knut B. and Smith, Scott E. and Smith, Stephen D. and Sundaram, Suchitra and Zayac, Adam S. and Zhang, Xiao Yin and Zhu, Catherine and Cheah, Chan Y. and El-Galaly, Tarec C. and Evens, Andrew M.}},
issn = {{0732-183X}},
language = {{eng}},
number = {{10}},
pages = {{1129--1138}},
publisher = {{American Society of Clinical Oncology}},
series = {{Journal of clinical oncology : official journal of the American Society of Clinical Oncology}},
title = {{Burkitt Lymphoma International Prognostic Index}},
url = {{http://dx.doi.org/10.1200/JCO.20.03288}},
doi = {{10.1200/JCO.20.03288}},
volume = {{39}},
year = {{2021}},
}