81-PERCENT EVENT-FREE SURVIVAL IN ADVANCED BURKITTS-LYMPHOMA LEUKEMIA- NO DIFFERENCES IN OUTCOME BETWEEN PEDIATRIC AND ADULT PATIENTS TREATED WITH THE SAME INTENSIVE PEDIATRIC PROTOCOL

Background: Advanced Burkitt's lymphoma (BL) has an extremely poor pro gnosis in adults. With a previous protocol including CNS prophylaxis, 40% of our adult patients achieved CR and only 13% became long survivo rs. In 1988, following this poor experience, we adopted a very intensi ve pediatric-derived protocol. Patients and methods: Twenty-one consec utive patients, 8 adults (median age 35, stage III: 1; IV: 7; leukemia s: 6) and 13 children (median age 10, stage III: 8; IV: 5; leukemias: 4) were treated with the same protocol (FOG 8617), based on alternate two-phase cycles with sequential high-dose CTX,VCR, ADM + CNS chemopro phylaxis (phase A) and HD MTX + HIDAC (phase B). Adults received 6 cyc les, children 8; i.t. prophylaxis in phase B was omitted in adults. Re sults: Twenty of 21 (95%) patients achieved CR (adults 100%, children 92%). Two patients died early; 2 relapsed at 4 and 9 months, With a me dian follow-up of 28 months (4-96), 17 patients (81%) are event free ( adults 75%, children 85%). Severe infections affected 62% of adults an d 15% of children. Conclusions: (1) The prognosis of adult advanced BL definitely improved with this intensive protocol. (2) There were no d ifferences in outcome between adults and children. (3) Outcome of lymp homa and leukemia was similar. (4) Severe infections occurred frequent ly in adults. This intensive pediatric protocol requires a careful sup portive therapy.