| Background:Burkitt lymphoma(BL)is a highly aggressive but potentially curable type of B-cell non-Hodgkin lymphoma(NHL)with a cellular doubling time of 24–48 hours.Derived from B-cell germinal centers,BL was first described as a distinct clinical entity in 1958.It was found to have a relationship with a viral infection(EBV).BL is also associated with a chromosomal translocation that activates the MYC proto-oncogene and is the first lymphoma reported to be associated with human immunodeficiency virus(HIV)infection.BL is one of the most common pediatric malignancies in sub-Saharan African countries,with an incidence rate as high as 4.7 cases per year for males and 3.0 cases per year for females(per 100 000children under 15 years of age).Three subtypes of BL are recognized:Endemic,Sporadic,and Immunodeficiency-associated.BL can be treated with high-dose chemotherapy regimens that have been shown to be more effective in younger patients versus elderly ones.Recent clinical studies have demonstrated that the use of anti-CD20 monoclonal antibody rituximab in combination with chemotherapy in BL yields encouraging results.Objective:The aim of this analysis is to analyse the clinical efficacy and safety of rituximab plus combination chemotherapy in treating human immunodeficiency virus–negative adults with Burkitt's lymphoma for those patients who use rituximab plus chemotherapy and for those who use chemotherapy alone without rituximab by perfoming meta analysis.Methods:A literature search Burkitt lymphoma was performed for English-language articles were retrieved from PubMed?Web of science and references listed in all studies.The releva nt articles published from January 1997 to October 2018.The following searching syntax“(rit uximab[Title/Abstract])AND Burkitt[Title/Abstract])AND(lymphoma[Title/Abstract])”was used for PubMed,while the syntax“TI=(rituximab AND Burkitt AND lymphoma)”was used for WOS.Random control trials(RCTs)studies were performed exclusive data were ext racted,the quality was evaluated and cross-checked by two reviewers independently accordin g to Cochrane Handbook for Systematic Reviews of Interventions and then Meta-analysis wer e conducted using Stata14.0 software.Results:A total of 9 studies and 807 patients were included.The pooled study of 455 patients in rituximab plus chemotherapy group showed to have higher complete remission(CR)of83.9%,respectively.Compared to chemotherapy alone,CR was 71.8%.Further more,7studies with 807 patients showed a higher survival rate in rituximab plus chemotherapy group,overall survival(OS)were 76.1%respectively.Compared with chemotherapy alone,OS were54.7%.The pooled OR for OS was significantly different between the two groups(OR:2.766,95%CI:2.023–3.781;P<0.001).There was no significant heterogeneity between the studies(I~2=16.7%;P=0.302).Importantly,Our data are consistent with those of the other previous published studies,where the range of CR was 66.6%to 94.4%and the OS was 70%to 89%.However,some patients developed infection and neutropenia,which was believed to be associated with chemotherapy.Conclusions:Rituximab addition regimens could be effective,safe and tolerable for HIV-free adult BL patients.The result of this meta-analysis supports the clinical applicability of Rituximab in BL patients,providing a relative high-level evidence and up-to-date data.However,further well-designed and large scales of RCT studies are needed to determine the value of Rituximab-plus therapy. |
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