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Treatment Results of 54 American Patients with Burkitt's Lymphoma Are Similar to the African Experience

List of authors.
  • John L. Ziegler, M.D.

Abstract

Burkitt's lymphoma in Africa may be curable by chemotherapy alone; in nonendemic regions results are reportedly less favorable. Fifty-four Americans with Burkitt's lymphoma were treated with two sequential combined treatment regimens that incorporated therapeutic approaches from clinical trials in Africa. Four patients died during induction therapy, and 48 of the remaining 50 achieved complete remissions. Twenty-two relapsed at a median of three months from the start of therapy. The overall two-year actuarial survival was 54 per cent: younger patients (<12 years old) and patients with minimal tumor burden (stages A, B and AR) had significantly better survivals than older patients (P<0.02) and patients with advanced abdominal tumors (stages C and D) (P<0.01). No differences in survival were detected between patients treated at the National Institutes of Health and those treated in their regional institutions on either protocol. Complete response rates, relapse frequency and survival in American patients are similar to results in Africa. (N Engl J Med 297:75–80, 1977)

Funding and Disclosures

The following physicians participated in this Cooperative trial: Costan Berard (National Cancer Institute, Bethesda, MD), Richard Binder (Georgetown University Medical School, Washington, DC), James Brown (Columbia College of Physicians and Surgeons, New York, NY), Jack Dalton, Elliot Perlin (National Naval Medical Center, Bethesda, MD), Marilyn Duncan (University of New Mexico School of Medicine, Albuquerque, NM), David Ginsburg (Etherington Hall, Kingston, ON), Charles Hess (University of Virginia Medical School, Charlottesville, VA), Ruth Heyn, David Tilford (University Hospital, Ann Arbor, MI), Patricia Joo (University of Wisconsin Medical School, Madison, WI), Herbert Kaizer (Johns Hopkins University Medical School, Baltimore, MD), William Knospe (Rush Presbyterian Medical Center, Chicago, IL), Rajan Krishnan (St. Joseph Mercy Hospital, Pontiac, MI), Vita Land (Washington University School of Medicine, St. Louis, MO), Charles Leff (1314 Park Ave., Plainfield, NJ), Arthur Levine (National Cancer Institute, Bethesda, MD), Harold Maurer (Medical College of Virginia, Richmond, VA), Nasser Movassaghi (Washington Children's Hospital, Washington, DC), Leo Neu (1211 So. Glenstone, Springfield, MO), Lou Popejoy (Madigan Army Medical Center, Tacoma, WA), Fred Ruymann, Alan Mease (Walter Reed Army Hospital, Washington, DC), Shanta Subramanian (St. Lukes Hospital, New York, NY), Thomas Pomeroy, Randall Fairey (National Cancer Institute, Bethesda, MD), John Wilson (Primary Children's Medical Center, Salt Lake City, UT), and Vincent DeVita, Robert Young and Tom Anderson (National Cancer Institute, Bethesda, MD). I am also indebted to the many physicians who referred their patients to the National Institutes of Health for study and treatment.

Author Affiliations

From the Clinical Oncology Program, Division of Cancer Treatment, National Cancer Institute, Bethesda, MD 20014, where reprint requests should be addressed to Dr. Ziegler.

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