Adult high-risk Burkitt's acute lymphocytic leukemia was successfully rescued by rituximab combined with hyper-CVAD/MA regimens: two case reports and a literature review

作者：Chen Zhiwei; Zhang Zhanglin; Huang Ping; Zhong Nan; Tang Weiping; Zhang Xiaojie; Wang Yunyun; Wei Yanlin; Li Fei^*

来源：International Journal of Clinical and Experimental Medicine, 2018, 11(4): 4262-4270.

• Burkitt
• acute lymphocytic leukemia
• MYC arrangement
• t(8
• 14)
• t(8
• 22)

Objective: We report two adult cases with high-risk Burkitt's acute lymphocytic leukemia (Burkitt's ALL) was successfully rescued by rituximab combined with hyper-CVAD (cyclophosphamide, vincristine, doxorubicin and dexamethasone)/MA (methotrexate and cytarabine) regimens. Methods: Two patients were diagnosed with high-risk Burkitt's ALL. One had a t(8; 22) chromosome translocation, respiratory failure, pulmonary infection, pleural effusion, hypoproteinemia, and his LDH was 13854 U/L; he developed central nervous system leukemia shortly thereafter. Another patient had a t(8; 14) chromosome translocation and was two months pregnant, and her LDH was 5664 U/L. They both initially received low-dose prephase chemotherapy followed by rituximab combined with a hyper-CVAD chemotherapy regimen. Results: Both patients achieved complete remission after a course of chemotherapy; the cerebrospinal fluid of patient one returned to normal levels after administration of methotrexate by intrathecal injection and high-dose MA chemotherapy. His lung infection gradually improved, and multiple high-density bilateral pulmonary plaques has been absorbed. The second patient safely underwent a medical abortion after her blood cell count returned to normal levels. Both patients are currently receiving an alternative chemotherapy regimen consisting of rituximab combined with hyper-CVAD/MA. Conclusion: Burkitt's ALL is a medical emergency and should be promptly diagnosed and treated with proper chemotherapy. Rituximab combined with hyper-CVAD/MA regimens may be an effective therapeutic strategy for patients to achieve the chance of survival.

• 出版日期2018
• 单位南昌大学