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Effect of rituximab on adult Burkitt’s lymphoma: a systematic review and meta-analysis

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Abstract

The treatment of Burkitt’s lymphoma with rituximab is controversial, and studies that compared the efficacy of chemotherapy alone with chemotherapy plus rituximab have not been powered to test differences in overall survival (OS). We conducted this systematic review and meta-analysis to identify the value of rituximab for the treatment of BL to guide treatment decisions. Based on the PubMed, Web of Science, and Cochrane library online electronic databases, all retrospective and randomized clinical trial studies that compared the aforementioned two regimens were included. The pooled hazard ratio and odds ratio were analyzed using Review Manager 5.3. The primary outcome was the 2-year OS. A total of 581 publications were identified using a predetermined search strategy. One randomized controlled trial (RCT) and five retrospective studies, which included 646 cases (351 cases for the chemotherapy with rituximab group and 295 cases for the chemotherapy alone group), fulfilled the selection criteria and were included in the meta-analysis. The chemotherapy with rituximab group was associated with a higher 2-year OS (hazard ratio 0.62, 95 % CI 0.45–0.85, P = 0.003), 2-year progression-free survival (hazard ratio 0.46, 95 % CI 0.43–0.50, P < 0. 001), and complete remission rate (odds ratios 3.26, 95 % CI 1.22–8.66, P = 0.02). In addition, the treatment-related mortality did not significantly differ between the two treatment regimens (odds ratio 1.16, 95 % CI 0.55–2.45, P = 0.69). The meta-analysis indicates that the addition of rituximab to the treatment regimen for Burkitt’s lymphoma may be associated with a significant survival benefit and did not increase the mortality compared with chemotherapy alone.

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Acknowledgments

We thank all of the pathologists, oncologists, radiologists, surgeons, and nurses who contributed to this study. This work was supported by the National Natural Science Foundation of China (project numbers 81472759 and 81301903), the Guangdong Natural Science Foundation (project number S2013010016331), the Science and Technology Planning Project of Guangdong Province, China (project number 2014J4100163), the Science and Technology Planning Project of Guangzhou, China (project number 2013B021800142), the Fundamental Research Funds for the Central Universities (no. 10ykpy36), and the Research Award Funds for Outstanding Young Researchers at Sun Yat-sen University Cancer Center.

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The authors have no conflict of interest to disclose.

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    Authors and Affiliations

    1. Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dong Feng East Road, Guangzhou, 510060, China

      Man Nie, Yu Wang, Xi-Wen Bi, Yi Xia, Peng Sun, Pan-Pan Liu, Zhi-Ming Li & Wen-Qi Jiang

    2. State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People’s Republic of China

      Man Nie, Yu Wang, Xi-Wen Bi, Yi Xia, Peng Sun & Pan-Pan Liu

    3. Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong, People’s Republic of China

      Man Nie, Yu Wang, Xi-Wen Bi, Yi Xia, Peng Sun & Pan-Pan Liu

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    Correspondence to Zhi-Ming Li or Wen-Qi Jiang.

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    Man Nie and Yu Wang contributed equally to this work.

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    Nie, M., Wang, Y., Bi, XW. et al. Effect of rituximab on adult Burkitt’s lymphoma: a systematic review and meta-analysis. Ann Hematol 95, 19–26 (2016). https://doi.org/10.1007/s00277-015-2501-1

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