Burkitt lymphoma remains one of the most challenging and aggressive high-grade B-cell lymphoma’s to manage. Investigators from the Burkitt lymphoma international prognostic index consortium, report their findings on a new prognostication model. Their hope is that it will be utilized to not only risk stratify patients, but also help interpret clinical trials and help develop targeted therapies.
The Burkitt lymphoma international prognostic index (BL-IPI) uses read overall data from adult patients treated with a combination of immunotherapy and chemotherapy, in the United States between years 2009 in 2018. The index that was developed, was validated and an external data set in patients outside of the United States including Europe, Canada in Australia between the years 2004 2019.
The derivation cohort included 633 patients. Of these patients , age over 40 years old, with an Eastern cooperative oncology group performance status of 0, 1 or 2, lactate dehydrogenase at least 3 times the upper limit of normal, as well as central nervous system involvement, were selected as equally weighted factors with an independent prognostic value. Patients are stratified into low, intermediate and high risk depending on the presence of factors, 0, 1 and at least 2, respectively. This translated into a 3-year progression free survival estimate of 92%, 72% of 53%. 3-year overall survival estimates were 96%, 76% and 59% respectively. HIV status and chemotherapy regimen were not discriminatory factors.
The authors concluded that the new index, provides robust discrimination of survival in adult patients with Burkitt lymphoma. They believe it is suitable for use as a prognostication and stratification index for clinical trials. Importantly, they feel that patients in the high risk group, will have suboptimal outcomes, and should be considered for innovative treatment options rather than standard therapy.