{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T02:04:34Z","timestamp":1791338674071,"version":"4.3.1"},"reference-count":36,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"10","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2021,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Burkitt lymphoma (BL) has unique biology and clinical course but lacks a standardized prognostic model. We developed and validated a novel prognostic index specific for BL to aid risk stratification, interpretation of clinical trials, and targeted development of novel treatment approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We derived the BL International Prognostic Index (BL-IPI) from a real-world data set of adult patients with BL treated with immunochemotherapy in the United States between 2009 and 2018, identifying candidate variables that showed the strongest prognostic association with progression-free survival (PFS). The index was validated in an external data set of patients treated in Europe, Canada, and Australia between 2004 and 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>In the derivation cohort of 633 patients with BL, age \u2265 40 years, performance status \u2265 2, serum lactate dehydrogenase &gt; 3\u00d7 upper limit of normal, and CNS involvement were selected as equally weighted factors with an independent prognostic value. The resulting BL-IPI identified groups with low (zero risk factors, 18% of patients), intermediate (one factor, 36% of patients), and high risk (\u2265 2 factors, 46% of patients) with 3-year PFS estimates of 92%, 72%, and 53%, respectively, and 3-year overall survival estimates of 96%, 76%, and 59%, respectively. The index discriminated outcomes regardless of HIV status, stage, or first-line chemotherapy regimen. Patient characteristics, relative size of the BL-IPI groupings, and outcome discrimination were consistent in the validation cohort of 457 patients, with 3-year PFS estimates of 96%, 82%, and 63% for low-, intermediate-, and high-risk BL-IPI, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The BL-IPI provides robust discrimination of survival in adult BL, suitable for use as prognostication and stratification in trials. The high-risk group has suboptimal outcomes with standard therapy and should be considered for innovative treatment approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco.20.03288","type":"journal-article","created":{"date-parts":[[2021,1,27]],"date-time":"2021-01-27T15:59:17Z","timestamp":1611763157000},"page":"1129-1138","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":83,"title":["Burkitt Lymphoma International Prognostic Index"],"prefix":"10.1200","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6472-6658","authenticated-orcid":false,"given":"Adam J.","family":"Olszewski","sequence":"first","affiliation":[{"name":"Lifespan Cancer Institute, The Warren Alpert Medical School of Brown University, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6575-7686","authenticated-orcid":false,"given":"Lasse H.","family":"Jakobsen","sequence":"additional","affiliation":[{"name":"Department of Haematology, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham P.","family":"Collins","sequence":"additional","affiliation":[{"name":"Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Cwynarski","sequence":"additional","affiliation":[{"name":"Department of Haematology, University College London Hospitals NHS Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika","family":"Bachanova","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4229-2569","authenticated-orcid":false,"given":"Kristie A.","family":"Blum","sequence":"additional","affiliation":[{"name":"Winship Cancer Institute, Emory University, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten M.","family":"Boughan","sequence":"additional","affiliation":[{"name":"Adult Hematologic Malignancies and Stem Cell Transplant Section, University Hospitals Seidman Cancer Center, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4077-6351","authenticated-orcid":false,"given":"Mark","family":"Bower","sequence":"additional","affiliation":[{"name":"National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Dalla Pria","sequence":"additional","affiliation":[{"name":"National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexey","family":"Danilov","sequence":"additional","affiliation":[{"name":"Toni Stephenson Lymphoma Center, City of Hope Comprehensive Cancer Center, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin A.","family":"David","sequence":"additional","affiliation":[{"name":"Rutgers Cancer Institute of New Jersey, New Brunswick, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1116-3246","authenticated-orcid":false,"given":"Catherine","family":"Diefenbach","sequence":"additional","affiliation":[{"name":"Perlmutter Cancer Institute, NYU Langone Health, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrik","family":"Ellin","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund, Oncology and Pathology, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8216-3457","authenticated-orcid":false,"given":"Narendranath","family":"Epperla","sequence":"additional","affiliation":[{"name":"The Ohio State University James Comprehensive Cancer Center, Columbus, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7891-9891","authenticated-orcid":false,"given":"Umar","family":"Farooq","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology, and Blood & Marrow Transplantation, University of Iowa, Iowa City, IA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatyana A.","family":"Feldman","sequence":"additional","affiliation":[{"name":"John Theurer Cancer Center, Hackensack Meridian Health School of Medicine, Hackensack, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4727-1425","authenticated-orcid":false,"given":"Alina S.","family":"Gerrie","sequence":"additional","affiliation":[{"name":"BC Cancer Centre for Lymphoid Cancer and The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepa","family":"Jagadeesh","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manali","family":"Kamdar","sequence":"additional","affiliation":[{"name":"University of Colorado Cancer Center, Aurora, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem","family":"Karmali","sequence":"additional","affiliation":[{"name":"Division of Hematology Oncology, Northwestern University, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shireen","family":"Kassam","sequence":"additional","affiliation":[{"name":"King's College Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaishalee P.","family":"Kenkre","sequence":"additional","affiliation":[{"name":"Carbone Cancer Center, University of Wisconsin, Madison, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8259-4129","authenticated-orcid":false,"given":"Nadia","family":"Khan","sequence":"additional","affiliation":[{"name":"Fox Chase Cancer Center, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1835-2998","authenticated-orcid":false,"given":"Seo-Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Hematology Oncology, Rush University Medical Center, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2559-8139","authenticated-orcid":false,"given":"Andreas K.","family":"Klein","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Tufts Medical Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9346-9013","authenticated-orcid":false,"given":"Izidore S.","family":"Lossos","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A.","family":"Lunning","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center, Omaha, NE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Martin","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine-New York Presbyterian Hospital, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5184-9464","authenticated-orcid":false,"given":"Nicolas","family":"Martinez-Calle","sequence":"additional","affiliation":[{"name":"Nottingham University Hospitals, NHS Trust, Nottingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3006-9725","authenticated-orcid":false,"given":"Silvia","family":"Montoto","sequence":"additional","affiliation":[{"name":"Department of Haemato-oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Naik","sequence":"additional","affiliation":[{"name":"Penn State Cancer Institute, Penn State Hershey Medical Center, Hershey, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1524-8108","authenticated-orcid":false,"given":"Neil","family":"Palmisiano","sequence":"additional","affiliation":[{"name":"Division of Hematologic Malignancies and Hematopoietic Stem Cell Transplantation, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9403-760X","authenticated-orcid":false,"given":"David","family":"Peace","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, University of Illinois College of Medicine, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth H.","family":"Phillips","sequence":"additional","affiliation":[{"name":"Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2143-9672","authenticated-orcid":false,"given":"Tycel J.","family":"Phillips","sequence":"additional","affiliation":[{"name":"University of Michigan Comprehensive Cancer Center, Dexter, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig A.","family":"Portell","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, University of Virginia, Charlottesville, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6059-9647","authenticated-orcid":false,"given":"Nishitha","family":"Reddy","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Santarsieri","sequence":"additional","affiliation":[{"name":"Department of Haematology, Cambridge University Hospitals NHSFT, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Sarraf Yazdy","sequence":"additional","affiliation":[{"name":"Georgetown University Hospital, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9832-4032","authenticated-orcid":false,"given":"Knut B.","family":"Smeland","sequence":"additional","affiliation":[{"name":"Department of Oncology, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott E.","family":"Smith","sequence":"additional","affiliation":[{"name":"Loyola University Medical Center, Maywood, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5354-7593","authenticated-orcid":false,"given":"Stephen D.","family":"Smith","sequence":"additional","affiliation":[{"name":"University of Washington\/Fred Hutchinson Cancer Research Center, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suchitra","family":"Sundaram","sequence":"additional","affiliation":[{"name":"Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7591-2069","authenticated-orcid":false,"given":"Adam S.","family":"Zayac","sequence":"additional","affiliation":[{"name":"Lifespan Cancer Institute, The Warren Alpert Medical School of Brown University, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Yin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8644-1813","authenticated-orcid":false,"given":"Catherine","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Haematology, University College London Hospitals NHS Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7988-1565","authenticated-orcid":false,"given":"Chan Y.","family":"Cheah","sequence":"additional","affiliation":[{"name":"Linear Clinical Research and Sir Charles Gairdner Hospital, Perth, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarec C.","family":"El-Galaly","sequence":"additional","affiliation":[{"name":"Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6900-1824","authenticated-orcid":false,"given":"Andrew M.","family":"Evens","sequence":"additional","affiliation":[{"name":"Rutgers Cancer Institute of New Jersey, New Brunswick, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"b1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61177-X"},{"key":"b2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-037505"},{"key":"b3","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-06-538504"},{"key":"b4","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2020.1747068"},{"key":"b5","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1996.14.3.925"},{"key":"b6","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdf253"},{"key":"b7","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-03-145128"},{"key":"b8","doi-asserted-by":"publisher","DOI":"10.1080\/1042819031000141301"},{"key":"b9","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdt414"},{"key":"b10","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01317-3"},{"key":"b11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1308392"},{"key":"b12","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.00303"},{"key":"b13","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28264"},{"key":"b14","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2011.593274"},{"key":"b16","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-13-33"},{"key":"b17","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-01-643569"},{"key":"b18","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16425"},{"key":"b19","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.09.2403"},{"key":"b20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2015.04.005"},{"key":"b21","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4067"},{"key":"b22","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1111\/j.2517-6161.1996.tb02080.x","volume":"58","author":"Tibshirani R","year":"1996","journal-title":"J R Stat Soc Ser B"},{"key":"b23","doi-asserted-by":"publisher","DOI":"10.1198\/016214506000000735"},{"key":"b24","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2012.05.003"},{"key":"b25","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000623"},{"key":"b26","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-01-623900"},{"key":"b27","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199309303291402"},{"key":"b28","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12736"},{"key":"b29","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21776"},{"key":"b30","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27918"},{"key":"b31","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2019.1654097"},{"key":"b32","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.15262"},{"key":"b33","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-03-563627"},{"key":"b34","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-12-4434"},{"key":"b35","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2019-122990"},{"key":"b36","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a014282"},{"key":"b37","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-06-095331"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.20.03288","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T22:39:37Z","timestamp":1724366377000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.20.03288"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,1]]},"references-count":36,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,4,1]]}},"alternative-id":["10.1200\/JCO.20.03288"],"URL":"https:\/\/doi.org\/10.1200\/jco.20.03288","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,1]]},"assertion":[{"value":"2020-11-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-19","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}