How is Burkitt lymphoma/Burkitt-like lymphoma (BL/BLL) and CNS involvement treated?

Updated: Dec 20, 2019
  • Author: Ali H Kanbar, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

If central nervous system (CNS) involvement is documented, patients are treated with a more intense intrathecal regimen during cycles 1 and 2. Cytarabine 70 mg (15 mg if administered into an Ommaya reservoir) is given on days 1, 3, and 5 of cycle 1 as well as on days 7 and 9 of cycle 2; in addition, intrathecal methotrexate 12.5 mg (2 mg if via Ommaya reservoir) on days 15 and 17 (cycle 1) and day 5 (cycle 2). For cycles 3 and 4, the usual prophylactic intrathecal doses of cytosine arabinoside (Ara-C) and methotrexate are given.

The MRC/NCRI LY1O trial investigated a modified dose of methotrexate (3 g/m2) and showed an overall survival of 67%, with decreased toxicity compared with the previous LY06 trial with full-dose methotrexate (6.7 g/m2). [58]


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