Combination chemotherapy in abdominal Burkitt's lymphoma

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Abstract
In a clinical trial, 42 patients with abdominal Burkitt's lymphoma (BL) were treated with a combination regimen, code-named CVA, consisting of cyclophosphamide (CTX), vincristine, and cystosine arabinoside. In addition, intrathecal methotrexate (i.t. MTX) was administered as prophylaxis against subsequent central nervous system (CNS) involvement. Induced remissions, relapse, and survival were compared with those in a preceding group of 44 patients with abdominal BL treated with CTX alone. Remission rate did not differ significantly in the two treatment groups, although induced remissions were higher in the CVA plus i.t. MTX-treated group (94% vs. 83%). Remission duration was significantly increased (p<.05) and CNS relapse significantly reduced (p<.05) in the group treated with CVA and i.t. MTX. The combination therapy was associated with higher early deaths during treatment, which adversely affected the overall survival. It is suggested that a reduction of the initial chemotherapeutic doses, particularly for patients with extensive tumor load, could further improve on the results of this trial.