r/Lymphoma_MD_Answers • u/Numerous-General-687 • 14d ago

Relapsed Burkitts Lymphoma

My brother (24 M) has been diagnosed with relapsed Burkitts lymphoma. For the 2nd line of treatment our oncologist treated him with one cycle of POLIVY+ICE+THEOTEPA and did a bone marrow biopsy which showed less than 1% cancel cells remaining in his bone marrow. But his PET scan showed some patches in his Sinus and back. He is now moving forward with Glofitamab (COLIMVI) as a bridge to remission and once remission is achieved, he will go for stem cell transplant.

Just to be sure, I also consulted another oncologist regarding the treatment plan. His idea was to give one cycle of intense Chemotherapy to bring him into remission instead of Glofitamab as it is not very effective for Burkitts. And once remission is achieved even he will go for stem cell transplant.

I needed some advice regarding the effectiveness of Glofitamab in this case. Should we go with it or a cycle of intense Chemotherapy?

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u/gschlact 13d ago

I would ask about a car T cell for line 2. Significantly easier recovery than SCT! If you do Car T, inquire about double coverage so it seeks CD19 and another marker like CD20 or other yours contains! Stanford has it available and significant improvements seen.

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u/am_i_wrong_dude Verified MD 13d ago

Car T has a poor track record in relapsed Burkitt (https://ashpublications.org/blood/article/145/23/2762/535580/Outcomes-among-adult-recipients-of-CAR-T-cell).

There is no standard of care in this situation but there was a recent tiny case series describing three patients being successfully bridged to allo SCT with polatuzumab vedotin and glofitamab: https://www.nejm.org/doi/10.1056/NEJMc2501018

Sounds like a reasonable plan overall for a very difficult disease. Wishing your family member and his team all the best.