Is the Use of Low-Intensity Therapy Effective in Adults with Burkitt’s Lymphoma?

Tanya Huang, Mercer University College of Pharmacy

Burkitt’s lymphoma (BL) is a type of non-Hodgkin lymphoma that is most prevalent in equatorial Africa. [1] There are three epidemiological subtypes of BL: endemic (African), sporadic (non-endemic), and immunodeficiency-related. [2] Chemotherapy treatments for BL are usually intensive short-cycle regimens due to the highly proliferative nature of the disease. However, they are associated with severe side effects in patients with immunodeficiencies, such as human immunodeficiency virus (HIV).

Previous attempts to use a significantly reduced intensity for BL in adults have not been successful. However, researchers have hypothesized that BL may be sensitive to genotoxic stress, leading to the prediction that prolonged exposure, not increased dose, as the therapeutic strategy for maximizing tumor cell death. Based on the concept, a study was conducted to compare efficacy of two different low-intensity regimens composed of etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (EPOCH-R) for sporadic or immunodeficiency-associated BL patients. [3] A summary is provided below. Continue reading