Evaluación de la supervivencia global a 24 meses en pacientes adultos con linfoma de burkitt: cohorte retrospectiva

ilustraciones, diagramas

Autores:
Pineda Arango, Harold Steven
Tipo de recurso:
Doctoral thesis
Fecha de publicación:
2023
Institución:
Universidad Nacional de Colombia
Repositorio:
Universidad Nacional de Colombia
Idioma:
spa
OAI Identifier:
oai:repositorio.unal.edu.co:unal/86630
Acceso en línea:
https://repositorio.unal.edu.co/handle/unal/86630
https://repositorio.unal.edu.co/
Palabra clave:
610 - Medicina y salud::616 - Enfermedades
610 - Medicina y salud::614 - Medicina Forense; incidencia de lesiones, heridas, enfermedades; medicina preventiva pública
Lymphatic Vessel Tumors
Lymphoma, B-Cell
Linfoma de Burkitt
Linfoma no Hodgkin
Tumores de Vasos Linfáticos
Linfoma de Células B
Burkitt Lymphoma
Lymphoma, Non-Hodgkin
Adulto
Pronostico
Supervivencia
Supervivencia sin progresión
Adult
Prognosis
Survival
Progression-free survival.
Rights
openAccess
License
Atribución-NoComercial 4.0 Internacional
id UNACIONAL2_272e4c191bb4bfad7b90c138b29d884c
oai_identifier_str oai:repositorio.unal.edu.co:unal/86630
network_acronym_str UNACIONAL2
network_name_str Universidad Nacional de Colombia
repository_id_str
dc.title.spa.fl_str_mv Evaluación de la supervivencia global a 24 meses en pacientes adultos con linfoma de burkitt: cohorte retrospectiva
dc.title.translated.eng.fl_str_mv Evaluation of 24-month overall survival in adult patients with burkitt lymphoma: retrospective cohort
title Evaluación de la supervivencia global a 24 meses en pacientes adultos con linfoma de burkitt: cohorte retrospectiva
spellingShingle Evaluación de la supervivencia global a 24 meses en pacientes adultos con linfoma de burkitt: cohorte retrospectiva
610 - Medicina y salud::616 - Enfermedades
610 - Medicina y salud::614 - Medicina Forense; incidencia de lesiones, heridas, enfermedades; medicina preventiva pública
Lymphatic Vessel Tumors
Lymphoma, B-Cell
Linfoma de Burkitt
Linfoma no Hodgkin
Tumores de Vasos Linfáticos
Linfoma de Células B
Burkitt Lymphoma
Lymphoma, Non-Hodgkin
Adulto
Pronostico
Supervivencia
Supervivencia sin progresión
Adult
Prognosis
Survival
Progression-free survival.
title_short Evaluación de la supervivencia global a 24 meses en pacientes adultos con linfoma de burkitt: cohorte retrospectiva
title_full Evaluación de la supervivencia global a 24 meses en pacientes adultos con linfoma de burkitt: cohorte retrospectiva
title_fullStr Evaluación de la supervivencia global a 24 meses en pacientes adultos con linfoma de burkitt: cohorte retrospectiva
title_full_unstemmed Evaluación de la supervivencia global a 24 meses en pacientes adultos con linfoma de burkitt: cohorte retrospectiva
title_sort Evaluación de la supervivencia global a 24 meses en pacientes adultos con linfoma de burkitt: cohorte retrospectiva
dc.creator.fl_str_mv Pineda Arango, Harold Steven
dc.contributor.advisor.none.fl_str_mv Combariza, Juan Felipe
dc.contributor.author.none.fl_str_mv Pineda Arango, Harold Steven
dc.contributor.orcid.spa.fl_str_mv Pineda Arango, Harold Steven [0009000979965246]
dc.subject.ddc.spa.fl_str_mv 610 - Medicina y salud::616 - Enfermedades
610 - Medicina y salud::614 - Medicina Forense; incidencia de lesiones, heridas, enfermedades; medicina preventiva pública
topic 610 - Medicina y salud::616 - Enfermedades
610 - Medicina y salud::614 - Medicina Forense; incidencia de lesiones, heridas, enfermedades; medicina preventiva pública
Lymphatic Vessel Tumors
Lymphoma, B-Cell
Linfoma de Burkitt
Linfoma no Hodgkin
Tumores de Vasos Linfáticos
Linfoma de Células B
Burkitt Lymphoma
Lymphoma, Non-Hodgkin
Adulto
Pronostico
Supervivencia
Supervivencia sin progresión
Adult
Prognosis
Survival
Progression-free survival.
dc.subject.armarc.eng.fl_str_mv Lymphatic Vessel Tumors
Lymphoma, B-Cell
dc.subject.decs.spa.fl_str_mv Linfoma de Burkitt
Linfoma no Hodgkin
Tumores de Vasos Linfáticos
Linfoma de Células B
dc.subject.decs.eng.fl_str_mv Burkitt Lymphoma
Lymphoma, Non-Hodgkin
dc.subject.proposal.spa.fl_str_mv Adulto
Pronostico
Supervivencia
Supervivencia sin progresión
dc.subject.proposal.eng.fl_str_mv Adult
Prognosis
Survival
Progression-free survival.
description ilustraciones, diagramas
publishDate 2023
dc.date.issued.none.fl_str_mv 2023
dc.date.accessioned.none.fl_str_mv 2024-07-26T14:27:00Z
dc.date.available.none.fl_str_mv 2024-07-26T14:27:00Z
dc.type.spa.fl_str_mv Trabajo de grado - Especialidad Médica
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/doctoralThesis
dc.type.version.spa.fl_str_mv info:eu-repo/semantics/acceptedVersion
dc.type.coar.spa.fl_str_mv http://purl.org/coar/resource_type/c_db06
dc.type.content.spa.fl_str_mv Text
dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/TD
format http://purl.org/coar/resource_type/c_db06
status_str acceptedVersion
dc.identifier.uri.none.fl_str_mv https://repositorio.unal.edu.co/handle/unal/86630
dc.identifier.instname.spa.fl_str_mv Universidad Nacional de Colombia
dc.identifier.reponame.spa.fl_str_mv Repositorio Institucional Universidad Nacional de Colombia
dc.identifier.repourl.spa.fl_str_mv https://repositorio.unal.edu.co/
url https://repositorio.unal.edu.co/handle/unal/86630
https://repositorio.unal.edu.co/
identifier_str_mv Universidad Nacional de Colombia
Repositorio Institucional Universidad Nacional de Colombia
dc.language.iso.spa.fl_str_mv spa
language spa
dc.relation.references.spa.fl_str_mv Swerdlow SH CEHNJEPSSHTJVJ, World Health Organization. WHO Classification of tumours of Haematopoietic and Lymphoid Tissues. Vol. Revised 4th Edition. International Agency for Research on Cancer; 2017. 1–588 p.
Roschewski M, Staudt LM, Wilson WH. Burkitt’s Lymphoma. Longo DL, editor. New England Journal of Medicine [Internet]. 2022 Sep 22;387(12):1111–22. Available from: http://www.nejm.org/doi/10.1056/NEJMra2025746
Ferry JA. Burkitt’s Lymphoma: Clinicopathologic Features and Differential Diagnosis. Oncologist. 2006 Apr 1;11(4):375–83.
Burkitt. Nature. Nature. 1962;194:232–4.
López C, Burkhardt B, Chan JKC, Leoncini L, Mbulaiteye SM, Ogwang MD, et al. Burkitt lymphoma. Nat Rev Dis Primers. 2022 Dec 1;8(1).
Thandra KC, Barsouk A, Saginala K, Padala SA, Barsouk A, Rawla P. Epidemiology of Non-Hodgkin’s Lymphoma. Vol. 9, Medical sciences (Basel, Switzerland). NLM (Medline); 2021.
Teras LR, DeSantis CE, Cerhan JR, Morton LM, Jemal A, Flowers CR. 2016 US lymphoid malignancy statistics by World Health Organization subtypes. CA Cancer J Clin. 2016 Nov 12;66(6):443–59.
Laurini JA, Perry AM, Boilesen E, Diebold J, Maclennan KA, Konrad Mü Ller-Hermelink H, et al. LYMPHOID NEOPLASIA Classification of non-Hodgkin lymphoma in Central and South America: a review of 1028 cases. 2012; Available from: http://ashpublications.org/blood/article-pdf/120/24/4795/1361357/zh805012004795.pdf
Pavlovsky M, Cubero D, Gladys ;, Agreda-V ´ Asquez P, Enrico A, Mela-Osorio MJ, et al. Clinical Outcomes of Patients With B-Cell Non-Hodgkin Lymphoma in Real-World Settings: Findings From the Hemato-Oncology Latin America Observational Registry Study [Internet]. 2022. Available from: https://ascopubs.org/go/authors/open-access
Combariza JF, Lombana M, Torres AM, Castellanos AM, Arango M. General features and epidemiology of lymphoma in Colombia. A multicentric study. Ann Hematol. 2015 Jun 1;94(6):975–80.
Kalisz K, Alessandrino F, Beck R, Smith D, Kikano E, Ramaiya NH, et al. An update on Burkitt lymphoma: a review of pathogenesis and multimodality imaging assessment of disease presentation, treatment response, and recurrence. Vol. 10, Insights into Imaging. Springer Verlag; 2019.
Dunleavy K. ASSOCIATED CONTENT Approach to the Diagnosis and Treatment of Adult Burkitt’s Lymphoma. 2018; Available from: https://doi.org/10.1200/JOP.
Magrath I. Epidemiology: Clues to the pathogenesis of Burkitt lymphoma. Vol. 156, British Journal of Haematology. 2012. p. 744–56.
Mbulaiteye SM, Anderson WF, Bhatia K, Rosenberg PS, Linet MS, Devesa SS. Trimodal age-specific incidence patterns for Burkitt lymphoma in the United States, 1973-2005. Int J Cancer. 2010 Apr 1;126(7):1732–9.
Lim ST, Karim R, Nathwani BN, Tulpule A, Espina B, Levine AM. AIDS-related Burkitt’s lymphoma versus diffuse large-cell lymphoma in the pre-highly active antiretroviral therapy (HAART) and HAART eras: Significant differences in survival with standard chemotherapy. Journal of Clinical Oncology. 2005;23(19):4430–8.
Slack GW, Gascoyne RD. MYC and Aggressive B-cell Lymphomas [Internet]. 2011. Available from: www.anatomicpathology.com
Crombie J, Lacasce A. The treatment of Burkitt lymphoma in adults [Internet]. 2021. Available from: http://ashpublications.org/blood/article-pdf/137/6/743/1799971/bloodbld2019004099c.pdf
Reutter K, Sandmann S, Rohde J, Müller S, Wöste M, Khanam T, et al. Reconstructing clonal evolution in relapsed and non-relapsed Burkitt lymphoma. Leukemia. 2021 Feb 1;35(2):639–43.
Gong C, Krupka JA, Gao J, Grigoropoulos NF, Giotopoulos G, Asby R, et al. Sequential inverse dysregulation of the RNA helicases DDX3X and DDX3Y facilitates MYC-driven lymphomagenesis. Mol Cell. 2021 Oct 7;81(19):4059-4075.e11.
Durani U, Hogan WJ. Emergencies in haematology: tumour lysis syndrome. Vol. 188, British Journal of Haematology. Blackwell Publishing Ltd; 2020. p. 494–500.
Bonnet C, Janssens A, Wu KL, Schroyens W, Van Hende V, Heimann P, et al. Practice Guidelines BHS Guidelines for the treatment of Burkitt’s lymphoma. Vol. 6, Belgian Journal of Hematology. 2015.
Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Zucca E, et al. Recommendations for initial evaluation, staging, and response assessment of hodgkin and non-hodgkin lymphoma: The lugano classification. Vol. 32, Journal of Clinical Oncology. American Society of Clinical Oncology; 2014. p. 3059–67.
Smeland S, Blystad AK, Kvaløy SO, Ikonomou IM, Delabie J, Kvalheim G, et al. Treatment of Burkitt’s/Burkitt-like lymphoma in adolescents and adults: a 20-year experience from the norwegian radium hospital with the use of three successive regimens. Vol. 15, Annals of Oncology. Oxford University Press; 2004. p. 1072–8.
Magrath L, Adde M, Shad A, Venzon D, Seibel N, Gootenberg J, et al. Adults and Children With Small Non-Cleaved-Cell Lymphoma Have a Similar Excellent Outcome When Treated With the Same Chemotherapy Regimen. Vol. 14, Journal of Clinical Oncology. 1996.
Stenning SP, Mead GM, Wright D, Sydes MR, Walewski J, Grigg A, et al. An international evaluation of CODOX-M and CODOX-M alternating with IVAC in adult Burkitt’s lymphoma: Results of United Kingdom Lymphoma Group LY06 study. Annals of Oncology. 2002;13(8):1264–74.
Thomas DA, Cortes J, O’brien S, Pierce S, Faderl S, Albitar M, et al. Hyper-CVAD Program in Burkitt’s-Type Adult Acute Lymphoblastic Leukemia. Vol. 17, Journal of Clinical Oncology. 1999.
Samra B, Khoury JD, Morita K, Ravandi F, Richard-Carpentier G, Short NJ, et al. Long-term outcome of hyper-CVAD-R for Burkitt leukemia/lymphoma and high-grade B-cell lymphoma: Focus on CNS relapse. Blood Adv. 2021 Oct 26;5(20):3913–8.
Hoelzer D, Walewski J, Viardot A, Hiddemann W, Spiekermann K, Serve H, et al. Improved outcome of adult Burkitt lymphoma/leukemia with rituximab and chemotherapy: report of a large prospective multicenter trial. Blood [Internet]. 2014;124(26):3870–9. Available from: http://ashpublications.org/blood/article-pdf/124/26/3870/1466166/3870.pdf
Noy A, Lee JY, Cesarman E, Ambinder R, Baiocchi R, Reid E, et al. AMC 048: Modified CODOX-M/IVAC-rituximab is safe and effective for HIV-associated Burkitt lymphoma. Blood. 2015 Jul 9;126(2):160–6.
Roschewski M, Dunleavy K, Abramson JS, Powell BL, Link BK, Patel P, et al. Multicenter Study of Risk-Adapted Therapy with Dose-Adjusted EPOCH-R in Adults with Untreated Burkitt Lymphoma. Journal of Clinical Oncology. 2020 May 26;38(22):2519–29.
Chamuleau M, Stenner F, Chitu D, Novak U, Minnema M, Visser O, et al. LB2370 R-CODOX-M/R-IVAC VERSUS DOSE-ADJUSTED(DA)-EPOCH-R IN PATIENTS WITH NEWLY DIAGNOSED HIGH-RISK BURKITT LYMPHOMA; FIRST RESULTS OF A MULTI-CENTER RANDOMIZED HOVON/SAKK TRIAL [Internet]. Vol. 15, Luzerner Kantonsspital and SAKK. 2022. Available from: https://journals.lww.com/hemasphere/pages/default.aspx.
López C, Burkhardt B, Chan JKC, Leoncini L, Mbulaiteye SM, Ogwang MD, et al. Burkitt lymphoma. Nat Rev Dis Primers. 2022 Dec 1;8(1).
Grillo-López AJ, Cheson BD, Horning SJ, Peterson BA, Carter WD, Varns CL, et al. Response criteria for NHL: Importance of “normal” lymph node size and correlations with response rates. Annals of Oncology. 2000;11(4):399–408.
Younes A, Hilden P, Coiffier B, Hagenbeek A, Salles G, Wilson W, et al. International Working Group consensus response evaluation criteria in lymphoma (RECIL 2017). Vol. 28, Annals of Oncology. Elsevier Ltd; 2017. p. 1436–47.
Olszewski AJ, Lasse ;, Jakobsen H, Collins GP, Cwynarski K, Bachanova V, et al. Burkitt Lymphoma International Prognostic Index. J Clin Oncol [Internet]. 2021;39:1129–38. Available from: https://doi.
Mukhtar F, Boffetta P, Risch HA, Park JY, Bubu OM, Womack L, et al. Survival predictors of Burkitt’s lymphoma in children, adults and elderly in the United States during 2000–2013. Int J Cancer. 2017 Apr 1;140(7):1494–502.
Evens AM, Danilov A, Jagadeesh D, Sperling A, Kim SH, Vaca R, et al. Burkitt lymphoma in the modern era: real-world outcomes and prognostication across 30 US cancer centers [Internet]. Vol. 137. 2021. Available from: http://ashpublications.org/blood/article-pdf/137/3/374/1797623/bloodbld2020006926.pdf
Yang X, Huang Q, Li A, Chen Y, Xu W, Li J, et al. A long-term retrospective study on sporadic Burkitt lymphoma in chinese population. Medicine. 2020 Jan 3;99(5):e18438.
Oosten LEM, Chamuleau MED, Thielen FW, de Wreede LC, Siemes C, Doorduijn JK, et al. Treatment of sporadic Burkitt lymphoma in adults, a retrospective comparison of four treatment regimens. Ann Hematol. 2018 Feb 1;97(2):255–66.
Silva WF da, Garibaldi PMM, Rosa LI da, Bellesso M, Clé DV, Delamain MT, et al. Outcomes of HIV-associated Burkitt Lymphoma in Brazil: High treatment toxicity and refractoriness rates – A multicenter cohort study. Leuk Res. 2020 Feb 1;89.
Fondo Colombiano de enfermedades de alto costo. Situación del Cancer en la Población Adulta atendida en el SGSSS de Colombia 2021. Bogotá D.C.; 2022. 1–284 p.
Cairo MS, Bishop M. Tumour lysis syndrome: New therapeutic strategies and classification. Vol. 127, British Journal of Haematology. 2004. p. 3–11.
Ministerio de salud. Resolución número 8430 de 1993, por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud. 1993.
Declaración de HELSINKI de la AMM.
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.license.spa.fl_str_mv Atribución-NoComercial 4.0 Internacional
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dc.format.extent.spa.fl_str_mv 44 páginas
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dc.coverage.temporal.none.fl_str_mv 2017-2021
dc.coverage.city.none.fl_str_mv Bogotá
dc.coverage.country.none.fl_str_mv Colombia
dc.publisher.spa.fl_str_mv Universidad Nacional de Colombia
dc.publisher.program.spa.fl_str_mv Bogotá - Medicina - Especialidad en Hematología
dc.publisher.faculty.spa.fl_str_mv Facultad de Medicina
dc.publisher.place.spa.fl_str_mv Bogotá, Colombia
dc.publisher.branch.spa.fl_str_mv Universidad Nacional de Colombia - Sede Bogotá
institution Universidad Nacional de Colombia
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spelling Atribución-NoComercial 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Combariza, Juan Felipe2232e92170580a6ecf5515a5dd7a5be3Pineda Arango, Harold Stevenbf689891144fa8af91b4a12021a012e2Pineda Arango, Harold Steven [0009000979965246]2017-2021BogotáColombia2024-07-26T14:27:00Z2024-07-26T14:27:00Z2023https://repositorio.unal.edu.co/handle/unal/86630Universidad Nacional de ColombiaRepositorio Institucional Universidad Nacional de Colombiahttps://repositorio.unal.edu.co/ilustraciones, diagramasEl linfoma de Burkitt representa aproximadamente entre el 1 al 2% de los linfomas no Hodgkin en adultos según datos de Estados Unidos, sin embargo, su frecuencia en Latinoamérica parece ser ligeramente mayor encontrándose en diferentes series que representa alrededor del 3% de los linfomas no Hodgkin. En Colombia un estudio de cohorte retrospectiva encontró que representa un 7% de los linfomas no Hodgkin. El linfoma de Burkitt es muy sensible al tratamiento, siendo un tumor altamente curable con supervivencia libre de evento a 3 años del 75% y tasas de supervivencia global del 83%. En un estudio retrospectivo realizado en Estados Unidos se demostró que los esquemas de tratamiento más comúnmente usados en 30 centros fueron hyper-CVAD, R-EPOCH y CODOX-M/IVAC, sin diferencias en cuanto a los desenlaces. En Brasil, Wellington F. da Silva y colaboradores, realizaron un estudio retrospectivo multicéntrico, de pacientes con linfoma de Burkitt asociado a VIH, los esquemas de tratamiento usados con mayor frecuencia fueron Hyper CVAD en el 53 % de los pacientes y CODOX-M/IVAC en el 18%, en el análisis univariado, no hubo diferencias en cuanto a tasa de respuesta completa o supervivencia global con respecto a la edad, carga viral, CD4, o tipo de tratamiento empleado. Con respecto a Colombia, no se encontraron estudios específicos sobre Linfoma de Burkitt en población adulta (Texto tomado de la fuente).Burkitt lymphoma represents approximately 1 to 2% of non-Hodgkin lymphomas in adults according to data from the United States; however, its frequency in Latin America seems to be slightly higher, being found in different series to represent around 3% of cases. non-Hodgkin lymphomas. In Colombia, a retrospective cohort study found that it represents 7% of non-Hodgkin lymphomas. Burkitt lymphoma is very sensitive to treatment, being a highly curable tumor with 3-year event-free survival of 75% and overall survival rates of 83%. A retrospective study conducted in the United States showed that the most commonly used treatment regimens in 30 centers were hyper-CVAD, R-EPOCH, and CODOX-M/IVAC, with no differences in outcomes. In Brazil, Wellington F. da Silva et al. conducted a multicenter retrospective study of patients with HIV-associated Burkitt's lymphoma. The most frequently used treatment regimens were Hyper CVAD in 53% of the patients and CODOX-M/ VIA in 18%, in the univariate analysis, there were no differences in terms of complete response rate or overall survival with respect to age, viral load, CD4, or type of treatment used. With respect to Colombia, no specific studies on Burkitt's Lymphoma in the adult population were found.Especialidades MédicasEspecialista en HematologíaEstudio observacional de supervivencia en una cohorte retrospectiva, de pacientes adultos con diagnóstico de novo confirmado de linfoma de Burkitt, atendidos en la Clínica Universitaria Colombia entre el 1° de enero 2017 y el 31 de diciembre 2021. Se describieron las características clínicas y demográficas, los esquemas de tratamiento utilizados en primera línea y la asociación entre diferentes esquemas de tratamiento y los desenlaces de supervivencia global y supervivencia libre de recaída.44 páginasapplication/pdfspaUniversidad Nacional de ColombiaBogotá - Medicina - Especialidad en HematologíaFacultad de MedicinaBogotá, ColombiaUniversidad Nacional de Colombia - Sede Bogotá610 - Medicina y salud::616 - Enfermedades610 - Medicina y salud::614 - Medicina Forense; incidencia de lesiones, heridas, enfermedades; medicina preventiva públicaLymphatic Vessel TumorsLymphoma, B-CellLinfoma de BurkittLinfoma no HodgkinTumores de Vasos LinfáticosLinfoma de Células BBurkitt LymphomaLymphoma, Non-HodgkinAdultoPronosticoSupervivenciaSupervivencia sin progresiónAdultPrognosisSurvivalProgression-free survival.Evaluación de la supervivencia global a 24 meses en pacientes adultos con linfoma de burkitt: cohorte retrospectivaEvaluation of 24-month overall survival in adult patients with burkitt lymphoma: retrospective cohortTrabajo de grado - Especialidad Médicainfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/acceptedVersionhttp://purl.org/coar/resource_type/c_db06Texthttp://purl.org/redcol/resource_type/TDSwerdlow SH CEHNJEPSSHTJVJ, World Health Organization. WHO Classification of tumours of Haematopoietic and Lymphoid Tissues. Vol. Revised 4th Edition. International Agency for Research on Cancer; 2017. 1–588 p.Roschewski M, Staudt LM, Wilson WH. Burkitt’s Lymphoma. Longo DL, editor. New England Journal of Medicine [Internet]. 2022 Sep 22;387(12):1111–22. Available from: http://www.nejm.org/doi/10.1056/NEJMra2025746Ferry JA. Burkitt’s Lymphoma: Clinicopathologic Features and Differential Diagnosis. Oncologist. 2006 Apr 1;11(4):375–83.Burkitt. Nature. Nature. 1962;194:232–4.López C, Burkhardt B, Chan JKC, Leoncini L, Mbulaiteye SM, Ogwang MD, et al. Burkitt lymphoma. Nat Rev Dis Primers. 2022 Dec 1;8(1).Thandra KC, Barsouk A, Saginala K, Padala SA, Barsouk A, Rawla P. Epidemiology of Non-Hodgkin’s Lymphoma. Vol. 9, Medical sciences (Basel, Switzerland). NLM (Medline); 2021.Teras LR, DeSantis CE, Cerhan JR, Morton LM, Jemal A, Flowers CR. 2016 US lymphoid malignancy statistics by World Health Organization subtypes. CA Cancer J Clin. 2016 Nov 12;66(6):443–59.Laurini JA, Perry AM, Boilesen E, Diebold J, Maclennan KA, Konrad Mü Ller-Hermelink H, et al. LYMPHOID NEOPLASIA Classification of non-Hodgkin lymphoma in Central and South America: a review of 1028 cases. 2012; Available from: http://ashpublications.org/blood/article-pdf/120/24/4795/1361357/zh805012004795.pdfPavlovsky M, Cubero D, Gladys ;, Agreda-V ´ Asquez P, Enrico A, Mela-Osorio MJ, et al. Clinical Outcomes of Patients With B-Cell Non-Hodgkin Lymphoma in Real-World Settings: Findings From the Hemato-Oncology Latin America Observational Registry Study [Internet]. 2022. Available from: https://ascopubs.org/go/authors/open-accessCombariza JF, Lombana M, Torres AM, Castellanos AM, Arango M. General features and epidemiology of lymphoma in Colombia. A multicentric study. Ann Hematol. 2015 Jun 1;94(6):975–80.Kalisz K, Alessandrino F, Beck R, Smith D, Kikano E, Ramaiya NH, et al. An update on Burkitt lymphoma: a review of pathogenesis and multimodality imaging assessment of disease presentation, treatment response, and recurrence. Vol. 10, Insights into Imaging. Springer Verlag; 2019.Dunleavy K. ASSOCIATED CONTENT Approach to the Diagnosis and Treatment of Adult Burkitt’s Lymphoma. 2018; Available from: https://doi.org/10.1200/JOP.Magrath I. Epidemiology: Clues to the pathogenesis of Burkitt lymphoma. Vol. 156, British Journal of Haematology. 2012. p. 744–56.Mbulaiteye SM, Anderson WF, Bhatia K, Rosenberg PS, Linet MS, Devesa SS. Trimodal age-specific incidence patterns for Burkitt lymphoma in the United States, 1973-2005. Int J Cancer. 2010 Apr 1;126(7):1732–9.Lim ST, Karim R, Nathwani BN, Tulpule A, Espina B, Levine AM. AIDS-related Burkitt’s lymphoma versus diffuse large-cell lymphoma in the pre-highly active antiretroviral therapy (HAART) and HAART eras: Significant differences in survival with standard chemotherapy. Journal of Clinical Oncology. 2005;23(19):4430–8.Slack GW, Gascoyne RD. MYC and Aggressive B-cell Lymphomas [Internet]. 2011. Available from: www.anatomicpathology.comCrombie J, Lacasce A. The treatment of Burkitt lymphoma in adults [Internet]. 2021. Available from: http://ashpublications.org/blood/article-pdf/137/6/743/1799971/bloodbld2019004099c.pdfReutter K, Sandmann S, Rohde J, Müller S, Wöste M, Khanam T, et al. Reconstructing clonal evolution in relapsed and non-relapsed Burkitt lymphoma. Leukemia. 2021 Feb 1;35(2):639–43.Gong C, Krupka JA, Gao J, Grigoropoulos NF, Giotopoulos G, Asby R, et al. Sequential inverse dysregulation of the RNA helicases DDX3X and DDX3Y facilitates MYC-driven lymphomagenesis. Mol Cell. 2021 Oct 7;81(19):4059-4075.e11.Durani U, Hogan WJ. Emergencies in haematology: tumour lysis syndrome. Vol. 188, British Journal of Haematology. Blackwell Publishing Ltd; 2020. p. 494–500.Bonnet C, Janssens A, Wu KL, Schroyens W, Van Hende V, Heimann P, et al. Practice Guidelines BHS Guidelines for the treatment of Burkitt’s lymphoma. Vol. 6, Belgian Journal of Hematology. 2015.Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Zucca E, et al. Recommendations for initial evaluation, staging, and response assessment of hodgkin and non-hodgkin lymphoma: The lugano classification. Vol. 32, Journal of Clinical Oncology. American Society of Clinical Oncology; 2014. p. 3059–67.Smeland S, Blystad AK, Kvaløy SO, Ikonomou IM, Delabie J, Kvalheim G, et al. Treatment of Burkitt’s/Burkitt-like lymphoma in adolescents and adults: a 20-year experience from the norwegian radium hospital with the use of three successive regimens. Vol. 15, Annals of Oncology. Oxford University Press; 2004. p. 1072–8.Magrath L, Adde M, Shad A, Venzon D, Seibel N, Gootenberg J, et al. Adults and Children With Small Non-Cleaved-Cell Lymphoma Have a Similar Excellent Outcome When Treated With the Same Chemotherapy Regimen. Vol. 14, Journal of Clinical Oncology. 1996.Stenning SP, Mead GM, Wright D, Sydes MR, Walewski J, Grigg A, et al. An international evaluation of CODOX-M and CODOX-M alternating with IVAC in adult Burkitt’s lymphoma: Results of United Kingdom Lymphoma Group LY06 study. Annals of Oncology. 2002;13(8):1264–74.Thomas DA, Cortes J, O’brien S, Pierce S, Faderl S, Albitar M, et al. Hyper-CVAD Program in Burkitt’s-Type Adult Acute Lymphoblastic Leukemia. Vol. 17, Journal of Clinical Oncology. 1999.Samra B, Khoury JD, Morita K, Ravandi F, Richard-Carpentier G, Short NJ, et al. Long-term outcome of hyper-CVAD-R for Burkitt leukemia/lymphoma and high-grade B-cell lymphoma: Focus on CNS relapse. Blood Adv. 2021 Oct 26;5(20):3913–8.Hoelzer D, Walewski J, Viardot A, Hiddemann W, Spiekermann K, Serve H, et al. Improved outcome of adult Burkitt lymphoma/leukemia with rituximab and chemotherapy: report of a large prospective multicenter trial. Blood [Internet]. 2014;124(26):3870–9. Available from: http://ashpublications.org/blood/article-pdf/124/26/3870/1466166/3870.pdfNoy A, Lee JY, Cesarman E, Ambinder R, Baiocchi R, Reid E, et al. AMC 048: Modified CODOX-M/IVAC-rituximab is safe and effective for HIV-associated Burkitt lymphoma. Blood. 2015 Jul 9;126(2):160–6.Roschewski M, Dunleavy K, Abramson JS, Powell BL, Link BK, Patel P, et al. Multicenter Study of Risk-Adapted Therapy with Dose-Adjusted EPOCH-R in Adults with Untreated Burkitt Lymphoma. Journal of Clinical Oncology. 2020 May 26;38(22):2519–29.Chamuleau M, Stenner F, Chitu D, Novak U, Minnema M, Visser O, et al. LB2370 R-CODOX-M/R-IVAC VERSUS DOSE-ADJUSTED(DA)-EPOCH-R IN PATIENTS WITH NEWLY DIAGNOSED HIGH-RISK BURKITT LYMPHOMA; FIRST RESULTS OF A MULTI-CENTER RANDOMIZED HOVON/SAKK TRIAL [Internet]. Vol. 15, Luzerner Kantonsspital and SAKK. 2022. Available from: https://journals.lww.com/hemasphere/pages/default.aspx.López C, Burkhardt B, Chan JKC, Leoncini L, Mbulaiteye SM, Ogwang MD, et al. Burkitt lymphoma. Nat Rev Dis Primers. 2022 Dec 1;8(1).Grillo-López AJ, Cheson BD, Horning SJ, Peterson BA, Carter WD, Varns CL, et al. Response criteria for NHL: Importance of “normal” lymph node size and correlations with response rates. Annals of Oncology. 2000;11(4):399–408.Younes A, Hilden P, Coiffier B, Hagenbeek A, Salles G, Wilson W, et al. International Working Group consensus response evaluation criteria in lymphoma (RECIL 2017). Vol. 28, Annals of Oncology. Elsevier Ltd; 2017. p. 1436–47.Olszewski AJ, Lasse ;, Jakobsen H, Collins GP, Cwynarski K, Bachanova V, et al. Burkitt Lymphoma International Prognostic Index. J Clin Oncol [Internet]. 2021;39:1129–38. Available from: https://doi.Mukhtar F, Boffetta P, Risch HA, Park JY, Bubu OM, Womack L, et al. Survival predictors of Burkitt’s lymphoma in children, adults and elderly in the United States during 2000–2013. Int J Cancer. 2017 Apr 1;140(7):1494–502.Evens AM, Danilov A, Jagadeesh D, Sperling A, Kim SH, Vaca R, et al. Burkitt lymphoma in the modern era: real-world outcomes and prognostication across 30 US cancer centers [Internet]. Vol. 137. 2021. Available from: http://ashpublications.org/blood/article-pdf/137/3/374/1797623/bloodbld2020006926.pdfYang X, Huang Q, Li A, Chen Y, Xu W, Li J, et al. A long-term retrospective study on sporadic Burkitt lymphoma in chinese population. Medicine. 2020 Jan 3;99(5):e18438.Oosten LEM, Chamuleau MED, Thielen FW, de Wreede LC, Siemes C, Doorduijn JK, et al. Treatment of sporadic Burkitt lymphoma in adults, a retrospective comparison of four treatment regimens. Ann Hematol. 2018 Feb 1;97(2):255–66.Silva WF da, Garibaldi PMM, Rosa LI da, Bellesso M, Clé DV, Delamain MT, et al. Outcomes of HIV-associated Burkitt Lymphoma in Brazil: High treatment toxicity and refractoriness rates – A multicenter cohort study. Leuk Res. 2020 Feb 1;89.Fondo Colombiano de enfermedades de alto costo. Situación del Cancer en la Población Adulta atendida en el SGSSS de Colombia 2021. Bogotá D.C.; 2022. 1–284 p.Cairo MS, Bishop M. Tumour lysis syndrome: New therapeutic strategies and classification. Vol. 127, British Journal of Haematology. 2004. p. 3–11.Ministerio de salud. Resolución número 8430 de 1993, por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud. 1993.Declaración de HELSINKI de la AMM.EstudiantesInvestigadoresMaestrosLICENSElicense.txtlicense.txttext/plain; charset=utf-85879https://repositorio.unal.edu.co/bitstream/unal/86630/1/license.txteb34b1cf90b7e1103fc9dfd26be24b4aMD51ORIGINAL1110448335.2024.pdf1110448335.2024.pdfTesis en Especialidad en Hematologíaapplication/pdf977956https://repositorio.unal.edu.co/bitstream/unal/86630/2/1110448335.2024.pdf8db54d9ee2542102d2e8daf63a5b6cebMD52THUMBNAIL1110448335.2024.pdf.jpg1110448335.2024.pdf.jpgGenerated Thumbnailimage/jpeg3993https://repositorio.unal.edu.co/bitstream/unal/86630/3/1110448335.2024.pdf.jpgbc949b29ff17558e1bf83b71e0b236a7MD53unal/86630oai:repositorio.unal.edu.co:unal/866302024-07-26 23:39:01.738Repositorio Institucional Universidad Nacional de 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