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Advances in Hematology
Volume 2012, Article ID 735392, 9 pages
http://dx.doi.org/10.1155/2012/735392
Clinical Study

HIV-Associated Burkitt Lymphoma: Good Efficacy and Tolerance of Intensive Chemotherapy Including CODOX-M/IVAC with or without Rituximab in the HAART Era

1Division of Hematology, St. Paul's Hospital and the University of British Columbia, Vancouver, BC, Canada V6T 1Z4
2Division of Hematology, St. Michael's Hospital and the University of Toronto, Toronto, ON, Canada M5S 1A1
3Division of Hematology, Sunnybrook Health Sciences Centre and the University of Toronto, Toronto, ON, Canada M5S 1A1
4Leukemia/BMT Program of British Columbia, BC Cancer Agency, Vancouver, BC, Canada V5Z 1M9
5British Columbia Centre for Excellence in HIV/AIDS (CFE), St. Paul's Hospital and the University of British Columbia, Vancouver, BC, Canada V6T 1Z4
6AIDS Research Program, St. Paul's Hospital and the University of British Columbia, Vancouver, BC, Canada V6T 1Z4

Received 11 June 2011; Accepted 6 September 2011

Academic Editor: Jeremy S. Abramson

Copyright © 2012 J. A. Rodrigo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The outcome of HIV-associated non-Hodgkin lymphoma (NHL) has improved substantially in the highly active antiretroviral therapy (HAART) era. However, HIV-Burkitt lymphoma (BL), which accounts for up to 20% of HIV-NHL, has poor outcome with standard chemotherapy. Patients and Methods. We retrospectively reviewed HIV-BL treated in the HAART era with the Magrath regimen (CODOX-M/IVAC R) at four Canadian centres. Results. Fourteen patients with HIV-BL received at least one CODOX-M/IVAC R treatment. Median age at BL diagnosis was 45.5 years, CD4 count 375 cells/mL and HIV viral load (VL) <50 copies/mL. Patients received PCP prophylaxis and G-CSF, 13 received HAART with chemotherapy and 10 rituximab. There were 63 episodes of toxicity, none fatal, including: bacterial infection, ; grade 3-4 hematologic toxicity, ; febrile neutropenia, ; oral thrush; and ifosfamide neurological toxicity, each. At a median followup of 11.7 months, 12 (86%) patients are alive and in remission. All 10 patients who received HAART, chemotherapy, and rituximab are alive. CD4 counts and HIV VL 6 months following BL therapy completion ( patients) were >250 cells/mL and undetectable, respectively, in 4. Conclusion. Intensive chemotherapy with CODOX-M/IVAC R yielded acceptable toxicity and good survival rates in patients with HIV-associated Burkitt lymphoma receiving HAART.