Effectiveness of rituximab plus chemotherapy in pediatric Burkitt lymphoma: A systematic review and meta-analysis.

Abstract

e22006 Background: Burkitt lymphoma is an aggressive non-Hodgkin lymphoma originating from mature B cells. This meta-analysis aims to assess the efficacy and safety of rituximab in treating Burkitt lymphoma among children and adolescents, evaluating its impact on survival outcomes. While rituximab is a standard of care for adults with Burkitt lymphoma, data on its use in younger patients remain limited. Methods: We systematically searched EMBASE, PubMed, and Cochrane databases for controlled trials comparing rituximab-based chemotherapy regimens with chemotherapy alone in pediatric Burkitt lymphoma. The primary outcomes were overall survival (OS), event-free survival (EFS), adverse events, incidence of secondary malignancies, and relapse or progression rates. Statistical analyses were performed using R software version 4.3.2 and a random-effects model, with heterogeneity assessed via I² analysis. Results: The analysis included 1,280 patients from 5 clinical trials. The age of patients ranged from 4 to 18 years. The results of our study indicate that the addition of rituximab to chemotherapy regimens demonstrated improved efficacy, with a higher OS rate (HR 0.52; 95% CI 0.11-0.93; p < 0.01) against control and EFS with (HR 0.50; 95% CI 0.21-0.79; p < 0.01) against control. Although the toxic events, secondary cancer and relapse or progression outcomes were not statistically significant with, respectively, Odds Ratio of 1.61 (95% CI 0.63-4.10; p = 0.317), 3.25 (95% CI 0.37-28.41; p = 0.286) and 0.44 (95% CI 0.02-10.61; p = 0.610). Conclusions: This review suggests that adding rituximab to standard chemotherapy is an effective treatment approach for Burkitt lymphoma in children and adolescents. Patients receiving the combination of rituximab and chemotherapy experienced improved OS rates compared to those receiving chemotherapy alone. Additionally, the combined therapy did not pose a significantly higher risk of toxic events. Therefore, incorporating rituximab represents a beneficial treatment approach for Burkitt lymphoma.