What is salvage therapy for relapsed/refractory Burkitt lymphoma/Burkitt-like lymphoma (BL/BLL)?

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

The majority of relapses occur during the first year of treatment for Burkitt lymphoma. Failure to achieve complete remission is a very poor prognostic sign. Those who remain free from disease at 10-12 months are considered cured, although reports of delayed relapses have been described in the African population and in patients with concurrent human immunodeficiency virus (HIV) infection.

The best management approach to these patients is not well defined. Most patients in this group respond poorly to salvage therapy, although some patients are reported to have long-term survival.

The salvage regimen typically incorporates chemotherapeutic agents to which the patient has had no previous exposure. The DHAP (dexamethasone at 40 mg PO for 4 d, high-dose cytarabine [Ara-C] at 2000 mg/m2 IV q12h for 2 doses, and cisplatin at 100 mg/m2 IV for 1 dose) regimen is often used as salvage therapy. Among these patients, those whose disease demonstrates some chemosensitivity are then referred for high-dose chemotherapy and autologous stem cell transplantation (SCT)/bone marrow transplantation (or allogeneic SCT in clinical trials). Patients with chemoresistant disease are usually referred for best supportive care (see the Sweetenham et al reference [63] ).


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