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Would you recommend alloHCT in a 41-year-old patient with aggressive Burkitt leukemia and ALS?

May 26, 2022

June 2022

Here’s how readers responded to a You Make the Call question about management options for a 41-year old patient with aggressive Burkitt leukemia and ALS.


Disclaimer: ASH does not recommend or endorse any specific tests, physicians, products, procedures, or opinions, and disclaims any representation, warranty, or guaranty as to the same. Reliance on any information provided in this article is solely at your own risk.


There is no evidence to support alloHCT for the treatment of newly diagnosed Burkitt lymphoma, so this patient should not undergo a transplant. I would estimate he has a 70% chance of being cured with R-CODOX-M/R-IVAC.

Marie-Christine Ngirabacu, MD
Hainaut, Belgium

ALPS is not sufficient indication for transplant. Comparing the percentage of relapses after other immunodeficiency syndromes to transplant-related mortality or chronic graft-versus-host disease after transplant, I would not proceed with alloHCT. 

Michalis Michael, MD, PhD
Nicosia, Cyprus

Yes, I would recommend alloHCT with matched sibling donor for this patient, as there is high chance of relapse.

Shad Ahmed, MD
Riyadh, Saudi Arabia

I would recommend alloHCT given the patient’s underlying ALPS.

Reena Jayani, MD
Nashville, Tennessee

Yes, this patient with ALPS and Burkitt lymphoma in complete remission would benefit from alloHCT. 

VA Arun, MBBS, MD
Chandigarh, India

Yes, I would recommend alloHCT for this patient.

Anastasia Skandalis, MD
Athens, Greece

In my opinion, alloHCT is indicated. Patients with Burkitt leukemia who relapse after current effective front-line therapies have a poor survival rate. Given that this patient is at high risk of relapse due to the aggressive presentation and concomitant ALPS condition, alloHCT is beneficial for consolidation. Secondly, alloHCT has shown success in patients with ALPS, especially if the disease is severe and matched donor is available.

Israr Khan, MBBS, MD
McDonough, Georgia

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