Minimal relapse risk and early normalization of survival for patients with Burkitt lymphoma treated with intensive immunochemotherapy: an international study of 264 real-world patients

Research output: Contribution to journalArticle


Non-endemic Burkitt lymphoma (BL) is a rare germinal centre B-cell-derived malignancy with the genetic hallmark of MYC gene translocation and with rapid tumour growth as a distinct clinical feature. To investigate treatment outcomes, loss of lifetime and relapse risk in adult BL patients treated with intensive immunochemotherapy, retrospective clinic-based and population-based lymphoma registries from six countries were used to identify 264 real-world patients. The median age was 47 years and the majority had advanced-stage disease and elevated LDH. Treatment protocols were R-CODOX-M/IVAC (47%), R-hyper-CVAD (16%), DA-EPOCH-R (11%), R-BFM/GMALL (25%) and other (2%) leading to an overall response rate of 89%. The two-year overall survival and event-free survival were 84% and 80% respectively. For patients in complete remission/unconfirmed, the two-year relapse risk was 6% but diminished to 0·6% for patients reaching 12 months of post-remission event-free survival (pEFS12). The loss of lifetime for pEFS12 patients was 0·4 (95% CI: −0·7 to 2) months. In conclusion, real-world outcomes of adult BL are excellent following intensive immunochemotherapy. For pEFS12 patients, the relapse risk was low and life expectancy similar to that of a general population, which is important information for developing meaningful follow-up strategies with increased focus on survivorship and less focus on routine disease surveillance.


  • Lasse H. Jakobsen
  • Knut B. Smeland
  • Tove Wästerlid
  • Jacob H. Christensen
  • Judit M. Jørgensen
  • Pär L. Josefsson
  • Andreas K. Øvlisen
  • Harald Holte
  • Yngvild N. Blaker
  • Jacob H. Grauslund
  • Jon Bjørn
  • Daniel Molin
  • Ingemar Lagerlöf
  • Karin E. Smedby
  • Katherine Colvin
  • Gita Thanarajasingam
  • Matthew J. Maurer
  • Thomas M. Habermann
  • Kevin W. Song
  • Katie Y. Zhu
  • Alina S. Gerrie
  • Chan Y. Cheah
  • Tarec C. El-Galaly
External organisations
  • Aalborg University Hospital
  • Aalborg University
  • Oslo university hospital
  • Karolinska University Hospital
  • Odense University Hospital
  • Aarhus University Hospital
  • Herlev Hospital
  • Zealand University Hospital
  • Copenhagen University Hospital
  • Uppsala University
  • Linköping University
  • Sir Charles Gairdner Hospital
  • Mayo Clinic
  • University of Western Australia, Crawley
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Hematology


  • Burkitt lymphoma, immunochemotherapy, prognosis, real-world patients, survival
Original languageEnglish
JournalBritish Journal of Haematology
Publication statusE-pub ahead of print - 2020
Publication categoryResearch