Efficacy of Pola-R-CHP and Autologous Stem Cell Transplantation in Untreated Burkitt Lymphoma: A Case Report.

BACKGROUND Burkitt lymphoma is an aggressive B-cell lymphoma curable with highly dose-intensive chemotherapy derived from pediatric leukemia regimens. However, the adverse event profile, including myelosuppression, infection, and multi-organ dysfunction, worsens with increasing age. This report describes the first case of an 56-year-old woman diagnosed with Burkitt lymphoma who was treated with upfront polatuzumab vedotin plus rituximab, cyclophosphamide, doxorubicin, and prednisone (Pola-R-CHP) followed by autologous stem cell transplantation consolidation. CASE REPORT An 56-year-old Asian female patient with reduced body weight and severe malnutrition and unfit for standard therapies had an aggravating onset of abdominal pain and constipation. Diagnosis of high-risk Burkitt lymphoma was made by pathological biopsy, with intermediate-sized mature malignant B cells that expressed CD10, bcl-6 but not bcl-2, with high Ki-67 index (90%) and c-MYC translocation. She was treated with Pola-R-CHP. After the first dose of therapy, her abdominal pain was rapidly relieved. A grade 3 pneumonia after the fourth cycle was treated with antibiotics and best supportive care. After 6 cycles of induction therapy, complete metabolic remission was confirmed by positron emission tomography/computed tomography (PET/CT). To consolidate the response, she underwent autologous stem cell transplantation, and afterward, complete metabolic remission status was maintained. The last CT scan showed a continuous response of 12.9 months after the initiation of chemoimmunotherapy. Follow-up was still ongoing through blood tests and CT examination every 3 months. CONCLUSIONS Upfront Pola-R-CHP had a quick and durable response and was well-tolerated in untreated Burkitt lymphoma. Further research is required to confirm the conclusions.