UNASSIGNED: e18541 Background: High intensity regimens have improved outcomes in @entity2109 , but the optimal regimen remains to be defined. Hyper-CVAD (hyperfractionated @entity786 , @entity1891 , @entity632 , and @entity619 alternating with @entity1499 and @entity2592 ) has been reported in a single-institution experience to yield a complete response (CR) rate of 81% and 3 year (yr) overall survival (OS) rate of 49% (Thomas et al, JCO 1999). With the addition of rituximab (R), a CR rate of 86% and 3 yr OS rate of 89% were reported by investigators from @entity601 Anderson (Thomas et al, @entity5 2006). METHODS: We retrospectively identified 23 @entity16090 -negative @entity1 with @entity2109 diagnosed from 1999-2008 who received HyperCVAD or R-HyperCVAD at Washington University School of Medicine, St. Louis, MO or the Medical College of Wisconsin, Milwaukee, WI. All cases were reviewed by hematopathologists and confirmed using the WHO 2008 classification, including immunohistochemistry and @entity517 in situ hybridization. Medical records were reviewed for baseline characteristics, treatment, and outcomes. RESULTS: Baseline characteristics include: mean age 40.7 yrs (range 20-70), 52.2% male, 87% white, 43.5% with bone marrow involvement, 26.1% with central nervous system involvement. Mean LDH at diagnosis was 1060 IU/L (range 175-5320), and mean @entity414 8.5 mg/dL (range 3-17). Six @entity1 received HyperCVAD and 17 received R-HyperCVAD. 20/23 @entity1 (87.0%) achieved CR [94.1% with R-HyperCVAD and 66.7% with HyperCVAD]. Median event free survival (EFS) was 71.9 months (95% CI 0-161 months) with R-HyperCVAD vs. 9.2 months (95% CI 0.0-19.7 months) without R [log rank chi-square 1.64, P=0.20]. 1-yr, 2-yr and median OS rates with R-HyperCVAD were 88.2%, 62.4% and 71.9 months (95% CI 0-146 months) respectively, versus 33.3%, 16.7% and 10.1 months (95%CI 0-20.5 months) without R [log rank chi-square 5.15, P=0.023]. CONCLUSIONS: In this two-institution experience of @entity2109 confirmed by rigorous hematopathology review, R-HyperCVAD resulted in durable remissions in approximately 60% of @entity1 with @entity2109 , significantly lower than the previously published report. While the addition of R has improved the outcome for @entity1 with @entity2109 , better approaches are still needed.

Hyper-CVAD and rituximab-hyperCVAD in @entity2109 ( XXXX ): A multi-institutional experience.

@entity632 :: ('MESH:D004317', 'Chemical') :: ['doxorubicin'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['Cancer'] @entity517 :: ('4609', 'Gene') :: ['c-myc'] @entity786 :: ('MESH:D003520', 'Chemical') :: ['cyclophosphamide'] @entity2109 :: ('MESH:D002051', 'Disease') :: ['BL'] @entity2592 :: ('MESH:D003561', 'Chemical') :: ['cytarabine'] @entity619 :: ('MESH:D003907', 'Chemical') :: ['dexamethasone'] @entity601 :: ('MESH:D009436', 'Disease') :: ['MD'] @entity1891 :: ('MESH:D014750', 'Chemical') :: ['vincristine'] @entity16090 :: ('11709', 'Species') :: ['HIV'] @entity1499 :: ('MESH:D008727', 'Chemical') :: ['methotrexate'] @entity414 :: ('MESH:D014527', 'Chemical') :: ['uric acid']
@entity2109 :: (MESH:D002051,Disease) :: ['BL']
