Addition of rituximab to hyper-CVAD improves overall survival in newly diagnosed Burkitt leukemia/lymphoma from the Middle East and North Africa region

Background: Burkitt leukemia/lymphoma (BL) is a highly aggressive malignancy treated with intensive combinational chemotherapy. However, there is paucity in the literature with regards to outcome in patients with BL from the Middle East and North Africa Region (MENA).Methods: We examined the impact of incorporation of the monoclonal antibody rituximab within a chemotherapy backbone of hyper-fractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone, cytarabine and methotrexate (hyper-CVAD). Between 2007 to 2016, a total of 21 patients were identified and data retrospectively collected with median follow up was 32 months (1.1-120). The cohort was stratified based on exposure to rituximab and there was no significant difference regarding gender, age, stage, presence of constitutional symptoms, baseline presenting blood counts and proportion of patients completing prescribed therapy regimen between the strata.Results: Estimated overall survival (OS) of the entire cohort at 2 years was 71.1%; however, patients who received rituximab in conjunction with hyper-CVAD had a statistically significant improvement in 2-year OS at 81.2% vs 40% (p=0.048).Conclusions: In conclusion, we observed that incorporation of rituximab within a hyper-CVAD backbone improved OS in BL patients from the MENA region. These results warrant further evaluation.

Serum Sclerostin Levels in Patients with Human Immunodeficiency Virus Infection and Their Association with Bone Turnover Markers and Bone Mineral Densitometry

BACKGROUND: The aim of the study was to compare serum sclerostin levels in human im-munodeficiency virus (HIV)-infected patients and healthy controls, and to evaluate their relationship with bone turnover markers (BTM) and bone mineral density (BMD). METHODS: We prospectively studied 33 HIV treatment-naive patients and 63 healthy individuals; matched for age and sex. Serum sclerostin levels, BTM, BMD were measured. Viral load and cluster of differentiation 4 (CD4) levels were also assessed in HIV-infected patients. RESULTS: The mean+/-standard deviation (SD) age of sample was 37.6+/-10.3 years (range, 19 to 59 years). Of the 96 subjects, 58 (60.4%) were male and 38 (39.6%) were female. Infection with HIV is associated with significant reduction in serum sclerostin levels (HIV-infected: 39.4+/-28.3 vs. non HIV: 76.6+/-15.7 pmol/L; P0.05). CONCLUSIONS: These findings suggest that untreated HIV and the resulting immune deficiency and/or systemic inflammation could be an important regulator of serum sclerostin in this population.