Analysis of the clinical characteristics and prognostic factors of multicenter childhood Burkitt leukemia.

Burkitt lymphoma (BL) is a B-cell malignancy with a rapid doubling time, originating in follicular germinal centers. We aimed to explore the characteristics and prognosis of childhood Burkitt leukemia. A total of 124 children with Burkitt leukemia enrolled during the 6-year period of China Net Childhood Lymphoma- mature B-cell lymphoma 2017 regimen (CNCL-B-NHL-2017) were assessed. The median age at onset was 7 years (1-15 years), with a male-to-female ratio of 4.17:1. Of the total, 50.8% children were aged 5-10 years. Children with Burkitt leukemia were more likely to have tumor lysis syndrome, renal insufficiency, lactate dehydrogenase (LDH) > 4 times, multiple organ involvement, and central nervous system infiltration at diagnosis, whereas those with large tumor mass were rare. Eleven children had pure Burkitt leukemia (8.9%), with no significant differences in relapse, progression, white blood cell counts at initial diagnosis, LDH levels, CNS infiltration, and rates of tumor lysis syndrome before treatment compared to those of children with tumor masses. (P > 0.05). The median follow-up time for the entire group was 32.85 months (0.4-70.7), with 3-year overall survival and event-free survival rates of 87.1% and 81.5%, respectively. Thirteen (10%) children progressed or relapsed during treatment, of which nine received chimeric antigen receptor T-cell therapy, with only three fatalities. The analysis identified residual disease at midterm evaluation (P = 0.024) and LDH elevation ≥ 2000 U/L (P = 0.014) as independent prognostic factors affecting survival. The CNCL-B-NHL-2017 protocol demonstrated significant efficacy in treating children with Burkitt leukemia.