{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T19:22:32Z","timestamp":1793992952043,"version":"4.8.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Burkitt lymphoma (BL), a rare, aggressive <jats:italic>MYC<\/jats:italic>-driven B-cell non-Hodgkin lymphoma (NHL), has endemic, sporadic, and immunodeficiency-associated variants. In Asia, BL accounts for 1\u20132% of lymphomas, with limited data available on adult outcomes. Although potentially curable, BL is associated with poor outcomes with low-intensity chemotherapy owing to rapid proliferation and chemoresistance. Therefore, high-intensity regimens including R-hyperCVAD\/MC (Course A of rituximab, cyclophosphamide, doxorubicin, vincristine, and dexamethasone; Course B of rituximab, methotrexate, and cytarabine) have been commonly used; however, no optimal strategy has been established.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included 69 adult patients with BL (age &amp;gt;15 years) diagnosed between 2009 and 2023 using the WHO criteria. Most of the patients were administered R-hyperCVAD\/MC, while rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) was administered to older patients or those with poor-performance-status to mitigate toxicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age of the patients was 55 years; 39.1% of the patients had Eastern Cooperative Oncology Group Performance Status (ECOG-PS) of 2\u20134, 62.3% had &amp;gt;1 extranodal site, 71.0% had stage IV, and 13.0% had central nervous system involvement. Furthermore, 13 (18.8%) patients were reclassified as BL after immunoglobulin heavy\u2010chain (IGH)\/<jats:italic>MYC<\/jats:italic> detection. Overall, 52 patients were administered R-hyperCVAD\/MC exclusively, 5 switched from R-CHOP, and 4 patients were primarily treated with R-CHOP owing to intolerance. At a median follow-up of 66.9 months, 5-year overall survival (OS) and event-free survival (EFS) were 69.5 and 65.2%, respectively and higher early mortality was observed in older patients (median survival: 3.9 months). Poor OS was associated with B-symptoms (hazard ratio [HR] 3.89, <jats:italic>p<\/jats:italic> = 0.003) and age \u2265 60 years (HR 2.54, <jats:italic>p<\/jats:italic> = 0.034); while poor EFS was associated with ECOG-PS 2\u20134 (HR 2.72, <jats:italic>p<\/jats:italic> = 0.024).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study revealed that R-hyperCVAD\/MC was effective but associated with high early mortality in older patients. Risk-adapted regimens and prognostic factors including age, B-symptoms, and ECOG-PS are crucial for optimizing treatment.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1614506","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T05:44:34Z","timestamp":1752126274000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and safety of rituximab-based chemoimmunotherapy in adult patients with Burkitt lymphoma in Korea"],"prefix":"10.3389","volume":"15","author":[{"given":"Gi-June","family":"Min","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ka Young","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong 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