Zifahamu sababu na tiba ya muwasho Sehemu za siri

By Dr Salim Amour

Kuwashwa sehemu za siri kunaweza kuwa dalili ya maradhi fulani kujumuisha maradhi ya uke kwa wanawake au muwasho na kuvimba kwa sehemu za siri za wanaume (jock itch). Bila kujali jinsia muwasho unaweza kusababishwa na ugonjwa wa ngozi, magonjwa ya zinaa au mzio (allery).

Kuwashwa makalioni hutokea pale ngozi inayozunguka njia ya haja kubwa inapokereketa ikiambatana na hamu ya kutaka kupakuna. Muwasho huongezeka pale unapokaa na kukiwa na unyevunyevu. Sababu kuu za kuwashwa matakoni ni kutojisafisha vizuri, kula vyakula vyenye viungo vingi sana, kuhara, vidonda kwenye njia ya haja kubwa, maambukizi ya fangasi, bawasiri(hemorrhoids), minyoo na kadhalika.

Mara nyingi muwasho sehemu za siri unaosababishwa na kitu huisha wenyewe kitu hicho kikiondolewa. Vitu vingine vinavyosababisha muwasho huhitaji matibabu ya hali ya juu zaidi, ikiwa unawashwa kwa muda mrefu ni vyema kuzungumza na daktari.

Nini husababisha Muwasho Sehemu za Siri za Mwanaume?

Kuwashwa uume au sehemu zingine za siri za mwanaume husababishwa na sababu zilezile zinazosababisha muwasho sehemu zingine za mwili. Maambukizi hasa ya magonjwa ya zinaa ndio chanzo kikuu cha kuwashwa uume. Sababu zingine ni maradhi ya fangasi, ugonjwa wa upele (scabies), kuwepo kwa chawa, mzio, maambukizi ya bakteria n.k

Nini husababisha Muwasho Sehemu za Siri za Mwanamke?

(1) Maambukizi ya Fangasi Ukeni (Vaginal Yeast Infection)
Ni moja ya tatizo kwa wanawake linalosababishwa na fangasi waitwao Candida. Dalili kuu ni uwashwa ukeni, kuvimba na kutoa uchafu mweupe kama maziwa ukeni.

(2) Ugonjwa wa kuvimba uke (Vulvovaginitis)
Ni ugonjwa unaoathiri kwa kuvimbisha sehemu za nje za uke na uke wenyewe. Dalili kuu ni kuwashwa ukeni, mkojo kuuma na kukereketa wakati wa kukojoa na kutokwa na uchafu ukeni.

(3) Kuvimba Uke baada ya hedhi kukoma (Postmenopausal Atrophic Vaginitis)
Ni ugonjwa wa kuvimba kwa uke baada ya hedhi kukoma. Hali hii huongeza maambukizi ukeni na huweza kusababisha maumivu wakati wa tendo la ndoa.

(4) Maambukizi ya Trikomonasi (Trichomonas Infection)
Ni ugonjwa wa zinaa unaosababishwa na kimelea aitwaye Trichomonas vaginalis. Dalili kuu ni muwasho katika uke au uume na kutokwa na uchafu ukeni.

(5) Ugonjwa wa Minyoo (Pinworm Infection)
Ni maambukizi ya minyoo wadogo sana wenye umbo la pini wanaoweza kuambukiza utumbo na kusambaa maeneo mbalimbali. Ugonjwa huu huwatokea sana watoto wa kati ya miaka 5 na 10.

(6) Inflamesheni ya Urethra (Urethritis)
Ni maambukizi kwenye urethra (ujia wa kutolea mkojo nje) yanasababisha kuvimba kwa urethra. Dalili kuu ni mkojo kuchoma, maumivu ya tumbo chini ya kitovu na kutokwa uchafu.

(7) Genital Warts
Ni vivimbe vidogo vinavyotokea juu ya ngozi sehemu za siri. Ugonjwa unaoenezwa kwa njia ya kujamiana na unasababishwa na virusi viitavyo Human papillomavirus (HPV). Vivimbe vinaweza sababisha muwasho na maumivu.

(8) Saratani ya sehemu ya nje ya Uke (Vulvar Cancer)
Ni saratani ya sehemu ya nje ya uke inayoambatana na kuwashwa sehemu ya nje ya uke.

(9) Ugonjwa wa Wasiwasi (Generalized Anxiety Disorder)
Ni ugonjwa ambao unaotokana na hofu ya matukio fulani. Wakati mwingine husababisha kujikuna sehemu mbalimbali hata sehemu za siri.

(10) Ugonjwa wa Sjogren (Sjogren's Syndrome)
Ni ugonjwa katika mfumo wa kinga ya mwili unaoathiri tezi zinazosaidia mwili kutengeneza unyevu nyevu kwenye macho na mdomo. Ugonjwa huu huathiri wanawake zaidi kuliko wanaume.

(11) Kisukari
Ni ugonjwa sugu wa kimetaboliki unaosababishwa na kasoro katika utengenezaji wa Insulin au utendaji kazi wake. Kisukari kilichokomaa kinaweza sababisha maumivu ya tumbo, kichefuchefu, kizunguzungu na kuwashwa sehemuza siri.

Wanaume wanapaswa kufuata hatua zifuatazo ili kusaidia kuepuka kuwashwa sehemu za siri :-
– Kuosha vizuri uume, na kwa wale ambao hawajatahiriwa wanapaswa kuosha kwa umakini zaidi hadi sehemu za ndani za govi.
– Ziweke sehemu zako za siri kutia ndani makalio katika hali ya usafi na ukavu, kwa maana unyevunyevu unaweza sababisha maambukizi. Matumizi ya poda ya Cornstarch yanaruhusiwa hasa kipindi cha joto kali.
– Vaa nguo isiyobana sana, iliyotengenezwa kwa vitu asilia kama pamba. Badili nguo ya ndani (chupi) angalau kila siku.
– Vaa kondomu kila unapofanya ngono na mwanamke usiyejua hali yake kiafya kiujumla.

Wanawake wanapaswa kufuata hatua zifuatazo ili kusaidia kuepuka kuwashwa sehemu za siri:-
– Baada ya kukojoa au kujisaidia, osha sehemu zako za siri kuanzia mbele(ukeni) kwenda nyuma(matakoni) ili kuzuia bakteria kutoka njia ya haja kubwani kuingia uken

Kaposi's Sarcoma

Kaposi's Sarcoma

By   Dr  Salim Amour

Kaposi's sarcoma (KS) is a type of cancer. Tumors with tiny new blood vessels grow below the surface of the skin and in membranes of your mouth, nose, eyes, and anus. It can spread to your lungs, liver, stomach, intestines, and lymph nodes, which are glands that help you fight infection.

Researchers have found that Kaposi's sarcoma is caused by a herpes virus, HHV-8, also called KSHV. It affects 8 times more men than women. It may spread through sexual contact, but we don't know for sure.

KS was once rare, affecting older men from Eastern European or Mediterranean families, young African men, or people who had undergone organ transplants. Now HIV is the most common cause.

Kaposi's sarcoma and HIV

Because people with HIV have weakened immune systems, they're more likely to develop certain cancers, including KS. Most severe cases happen when someone has AIDS, the late stage of HIV infection, but skin lesions can also show up earlier. They're a sign your immune system isn't at full strength.

Skin lesions tend to get worse when you also have other infections.

Treating the HIV virus with antiretroviral therapy (ART) is the best way to treat KS, too, especially early on. Anti-HIV drugs have dropped the rate of KS cases by 80%-90% from the beginning of the AIDS epidemic in the early 1980s.

Symptoms

The most visible signs of Kaposi's sarcoma are lesions on the skin: flat, painless spots that are red or purple on white skin and bluish, brownish, or black on dark skin. Unlike bruises, they don't turn white when you press on them. They aren't itchy, and they don't drain. They're not life-threatening.

New spots may show up each week. For some people, these lesions change slowly. They may grow into raised bumps or grow together.

When KS spreads elsewhere, it can be life-threatening. You may have:

• Trouble eating or swallowing
• Queasiness, vomiting, and belly pain from bleeding and blockages inside
• Severe swelling in your arms, legs, face, or scrotum
• Serious coughing or shortness of breath

Diagnosis

Your doctor may diagnose Kaposi's sarcoma simply by looking at your skin. To confirm it, he may take a sample of tissue from a spot and look at it under a microscope, which is called a biopsy.

If you have trouble breathing, your doctor may use a thin tube with a light (a bronchoscope) to look into your breathing passages. Or, if you have tummy troubles, he may want to look inside your guts through a lighted tube during a procedure called an endoscopy.

Treatment

Your treatment will depend on how many lesions you have and how big they are and where they are, as well as how well your immune system is working.

In many cases, ART is the best way to treat active Kaposi's sarcoma. It may even clear up the skin lesions.

If you have just a few, you could have them removed. That won't cure you, but it can make your skin look better. Your doctor can cut the tissue out or freeze it to destroy it.

Radiation can kill the cancer cells or keep them from growing. A machine can direct it toward your body, or your doctor may put radioactive needles, seeds, or wires inside you near the cancer.

Once KS has spread, you'll need meds that go throughout your whole body to kill the cancer. Chemotherapy drugs for Kaposi's sarcoma include:

• Doxorubicin (Dox-SL, Doxil, Evacet, LipoDox)
• Paclitaxel (Taxol)
• Vinblastine (Velban, Velsar)

Chemotherapy can have side effects, including hair loss, vomiting, and fatigue. If you're HIV-positive, you also need to consider that chemo can lower your platelet and white-blood-cell counts, and raise your chances of an infection.

Another type of drug treatment, called biological therapy, works by boosting your immune system. Your doctor may prescribe interferon alfa (Intron A) if your CD4 cell count is over 200 and you have a fairly healthy immune system.

Targeted therapies, such as monoclonal antibody therapy and tyrosine kinase inhibitors (TKIs), are being tested in clinical trials. These try to attack the cancer and keep it from growing without harming healthy cells

Thank you !

Burkitt’s lymphoma

Burkitt’s lymphoma

By Dr Salim Amour

What is Burkitt’s lymphoma?

Burkitt’s lymphoma is a type of high-grade non-Hodgkin lymphoma that develops from B lymphocytes (B cells). It is one of the fastest growing lymphomas. This means though that it is more likely to be cured by treatment than many other types of lymphoma.

Burkitt’s lymphoma is named after a doctor called Denis Burkitt’s. He first wrote about a form of this lymphoma after seeing children and young adults with it in Africa. The kind of Burkitt’s lymphoma he described is now called ‘African-type’ (or ‘endemic’) Burkitt’s lymphoma. Another kind (the ‘sporadic’ type) is more often seen in the Western world.

Who gets Burkitt’s lymphoma?

Burkitt’s lymphoma is not common: only 1 in every 30–50 people with a B-cell non-Hodgkin lymphoma will have this type of lymphoma.

Both children and adults can be affected by Burkitt’s lymphoma (sporadic type). It makes up over a third of all the lymphomas seen in children. It is quite common in adolescents and young adults too. The number of people over 60 who are diagnosed with this type of lymphoma is also increasing.

Men and boys are more likely to get Burkitt’s lymphoma – more than two-thirds of adults with Burkitt’s lymphoma are men.

What causes Burkitt’s lymphoma?

The endemic (African) type of Burkitt’s lymphoma is almost always linked to a previous infection with the Epstein–Barr virus (EBV). This is the virus that causes glandular fever.

In the type of Burkitt’s lymphoma seen in the UK – the sporadic type – the role of EBV is less certain. EBV is a common virus: blood tests show that 9 out of 10 adults in the UK have had this infection at some time in their life. It is not clear why a few people develop lymphoma while most do not.

Although this lymphoma is sometimes linked to a virus, it is important that you know:

Ø  You cannot catch lymphoma.

Ø  You did not inherit it from your parents.

Ø  You cannot pass it on to others.

Having a weakened immune system also makes some people more likely to develop Burkitt’s lymphoma. For example, this might affect people with HIV (human immunodeficiency virus) infection.

Most patients with Burkitt’s lymphoma will not have HIV infection, but everyone should have a blood test to rule this out. It would be very important to treat the HIV infection as well as the lymphoma if it was found.

What are the symptoms?

The symptoms of Burkitt’s lymphoma often come on over just a few weeks because the lymphoma cells are dividing so quickly. For the same reason, many people have this lymphoma in several places by the time it is diagnosed.

You will probably have:

Ø  Swelling of one or more groups of lymph nodes in different parts of your body.

You may also have:

Ø  Abdominal pain, sickness and/or diarrhea – Burkitt’s lymphoma commonly affects the bowel

Ø  A very swollen abdomen caused by a collection of fluid within your abdomen (called ‘ascites’)

Ø  More serious bowel problems such as bowel obstruction or bleeding from your bowel

Ø  lymphoma in an extra nodal site (outside the lymphatic system) – this is common, involving organs such as the liver, kidneys, ovaries and breasts – symptoms will depend on the site

Ø  other symptoms of lymphoma, including

o   drenching sweats, especially at night

o   tiredness or fatigue

o   fever and flu-like symptoms, and

o   loss of appetite and weight loss

Ø  low blood counts due to lymphoma in the bone marrow – this is common in Burkitt’s lymphoma and can lead to

o   anaemia, causing shortness of breath and tiredness

o   low platelets, making you more likely to bleed or bruise very easily

Ø  lymphoma cells seen on a blood sample when looked at under the microscope

Ø  lymphoma in your brain and spinal cord (known as your ‘central nervous system’ or CNS), which can cause many different symptoms including

o   headache

o   seizures

o   confusion

o   inability to concentrate.

In children with the endemic type, Burkitt’s lymphoma often affects the jaw. It seems to grow in the areas where the permanent teeth are forming. This rarely happens in the sporadic (Western) type.

Tests for Burkitt’s lymphoma

Burkitt’s lymphoma is usually diagnosed by a biopsy of a swollen lymph node or another affected tissue. In a few people, Burkitt’s lymphoma will be found first in the bone marrow or in tissues removed for other reasons – in this case, lymphoma may not have been suspected before.

Wherever the biopsy comes from, it will be examined by an expert pathologist to make the diagnosis. Other specialist laboratory tests on the biopsy may include looking for:

Ø  specific proteins on and within the cells

Ø  changes within the genes of the cell – in Burkitt’s lymphoma, a gene known as MYC changes position and overworks, which makes the cells divide very quickly.

Ø  It is important to identify Burkitt’s lymphoma correctly because it needs to be treated differently from most high-grade lymphomas.

Ø  As well as a biopsy, you will have other tests to find out more about:

Ø  your general health

Ø  The stage of your lymphoma – a guide to how many (and which) areas of your body are affected by the lymphoma.

Ø  Most people with Burkitt’s lymphoma will have blood tests, scans such as a CT scan, MRI scan or PET/CT scan, a bone marrow test and a lumbar puncture.

Ø  Further tests that are sometimes done can include:

Ø  An electrocardiogram (ECG), echocardiogram (often just called an echo) or MUGA scan to assess how well your heart is working

Ø  A 24-hour urine collection to assess how well your kidneys are working.

Staging of Burkitt’s lymphoma

The ‘stage’ of your lymphoma shows which parts of your body have been affected.

There are four stages, which are written with Roman numerals as stage I to stage IV. Your doctors will use one of two ways to work out the stage of your Burkitt’s lymphoma, either:  

·         The Ann Arbor system – the system used for most other lymphomas, particularly in adults
or

·         The St Jude/Murphy staging system – a system more often used for lymphomas in children.

Stage I

One site only, which can be either a group of lymph nodes or an extra nodal site
(unless, for the St Jude/Murphy system, the one site is in the chest or the abdomen – see stages II/III)

Stage II

Lymphoma on one side of the diaphragm but in two or more sites, which may be groups of lymph nodes or extra nodal sites or a mixture
(Lymphoma in the abdomen that has been completely removed by surgery is also stage II when using the St Jude/Murphy system)

Stage III

Lymphoma on both sides of the diaphragm, whether in groups of lymph nodes or extra nodal sites
(Lymphoma that started in the chest or alongside the spine and lymphoma in the abdomen that cannot be completely removed by surgery, when using the St Jude/Murphy system, are also stage III)

Stage IV

Lymphoma in the bone marrow or in the central nervous system 
(and, for the Ann Arbor system, lymphoma in the liver or in extra nodal sites that are not close to each other).

Using the stage, your doctors will decide whether to treat your Burkitt’s lymphoma as ‘favourable’ or not. Favorable lymphomas are stage I lymphomas (and some stage II lymphomas) that are not causing a rise in a blood test called ‘LDH’.

If your doctors use the Ann Arbor system, they will also look at:

·         How much you are able to do (known as your ‘performance status’), for instance whether you are up and about and able to carry out light work

·         Whether your lymphoma is in more than one extra nodal site.

Do not be alarmed if the doctors do not class your lymphoma as favourable. In fact, very few adults have favourable Burkitt’s lymphoma. The treatments usually work well for everybody with Burkitt’s lymphoma, but those with ‘favourable’ disease may need slightly less treatment.

Treatment of Burkitt’s lymphoma

Intravenous chemotherapy

Burkitt’s lymphoma is always treated with chemotherapy, even if the lymphoma is localized (early stage). The regimens used for Burkitt’s lymphoma involve:

Ø  Several different drugs that target the lymphoma cells in different ways

Ø  Drugs being given on several consecutive days.

This type of chemotherapy has the best chance of killing most of the lymphoma cells as quickly as possible. The regimens are typically given intravenously (into a vein) as an infusion (a drip).

People having these regimens will need to be inpatients because:

Ø  Some of the drugs take several hours to give

Ø  You will need lots of fluids in your drip to keep your kidneys working well

Ø  The whole treatment takes several days to give

Ø  You will also need lots of tests after having the chemotherapy to check your kidneys and liver and your blood cell counts.

When you first start chemotherapy, many of the tests you will have will be done to look for signs of ‘tumour lysis syndrome’. This happens when lots of lymphoma cells are killed very quickly and is most likely to occur in very fast-growing lymphomas.

The chemicals that were in the lymphoma (tumour) cells spill out into the bloodstream. The body struggles to get rid of the extra chemicals through the kidneys and rebalance the salts in the blood. The extra fluids in your drip help with this, and the blood tests will show if any problems are starting to develop. Serious problems could occur if the levels of salts in the blood became very abnormal (these can affect the way the heart and kidneys work) or if the kidneys were overwhelmed by uric acid (one of the chemicals they need to get rid of).

Tumour lysis syndrome is a serious condition, which needs to be prevented if possible or treated at the first sign. Fortunately, the drug rasburicase (Fasturtec^®) can help if it does occur, or can be given to people at high risk of the condition to prevent it developing. In a way it should be thought of as a good sign, as it means the chemotherapy has already killed many of the lymphoma cells.

To make all this treatment easier, your doctors will probably recommend you have a tunnelled central line or possibly a PICC line (peripherally inserted central catheter).

Other treatments

You are likely to have many of these treatments too:

Ø  Rituximab (MabThera^®), usually given with chemotherapy to adults with Burkitt’s lymphoma

Ø  Mesna and folinic acid, to protect against some of the side effects of the chemotherapy drugs used in these regimens

Ø  Anti-sickness drugs (antiemetics)

Ø  Rasburicase (Fasturtec^®) initially and allopurinol in later cycles, to protect against tumour lysis syndrome

Ø  Prophylactic (preventive) antibiotics and antifungal, to reduce the risks of infection

Ø  Growth factors (G-CSF), to help your bone marrow recover quickly.

Intrathecal chemotherapy

In Burkitt’s lymphoma, treatment that targets the CNS (the brain and spinal cord) is also needed. You may hear this treatment called ‘CNS-directed therapy’ or ‘CNS prophylaxis’.

Some intravenous drugs will reach the CNS, but Intrathecal chemotherapy is another way to get drugs to the brain and spinal cord. It means giving chemotherapy directly into the cerebrospinal fluid (the fluid that bathes the brain and spinal cord). Only a few drugs can be given in this way (most often methotrexate and cytarabine).

Normally Intrathecal chemotherapy is given during a lumbar puncture. Sometimes a device called an ‘Ommaya reservoir’ is put in to avoid the need for lots of lumbar punctures.

Possible chemotherapy regimens

The exact treatment you have will depend on:

Ø  Your general health and usual level of fitness

Ø  Whether your doctors class your lymphoma as favourable or not (as explained in the section on staging)

Ø  How well you and your doctors think you will cope with the likely effects of the treatment.

Ø  No matter which chemotherapy regimen you have, your whole treatment will probably take several months. You should expect to spend days or even weeks at a time in hospital.

Ø  R-CODOX-M is one regimen that is commonly used for adults in the UK. It is made up of:

Ø  rituximab

Ø  cyclophosphamide – daily for 5 days

Ø  vincristine (Oncovin^®)

Ø  doxorubicin

Ø  methotrexate – given over 24 hours.

Ø  Three cycles of R-CODOX-M are usually given to people with ‘favourable’ Burkitt lymphoma. For most people, with less favourable Burkitt lymphoma, R-CODOX-M is alternated with R-IVAC – usually two cycles of each.

Ø  R-IVAC is made up of:

Ø  rituximab

Ø  ifosfamide – daily for 5 days

Ø  etoposide (VP-16 or VePesid^®) – daily for 5 days

Ø  cytarabine (Ara-C) – for the first 2 days.

Ø  R-hyper-CVAD is another regimen that can be used for Burkitt lymphoma. It is made up of:

Ø  rituximab

Ø  frequent small doses of (hyperfractionated) cyclophosphamide – given over 3 days

Ø  vincristine

Ø  doxorubicin (Adriamycin^®)

Ø  dexamethasone – as tablets for 4 days.

Ø  This combination is alternated with high-dose methotrexate and cytarabine (given over 3 days). Typically four cycles of each will be given.

Ø  DA-EPOCH-R is another regimen that has been used in trials with some promising results. It is made up of dose-adjusted:

Ø  etoposide – infused continuously over 4 days (with the vincristine and doxorubicin)

Ø  prednisolone – tablets for 5 days

Ø  vincristine (Oncovin^®) – infused continuously over 4 days

Ø  cyclophosphamide

Ø  hydroxydaunorubicin (often called doxorubicin) – infused continuously over 4 days (in people who are well enough it may be possible to give this through a portable device as an outpatient treatment)

Ø  rituximab.

Ø  In children and adolescents, several different regimens, which formed part of the LMB96 trial, are combined. These include:

Ø  two cycles of COPADM, made up of

o   cyclophosphamide

o   vincristine (Oncovin^®)

o   prednisolone

o   doxorubicin (Adriamycin^®)

o   Methotrexate.

Ø  This is followed by other chemotherapy regimens, depending on how advanced the lymphoma is and how it responds to early treatment, such as:

Ø  CYVE – cytarabine and etoposide (VePesid^®)

Ø  CYM – cytarabine and methotrexate.

Recently, trials in young people, who are very likely to be cured, have looked at reducing treatment wherever possible to limit the long-term side effects.

What are the side effects of chemotherapy?

If you are having intensive chemotherapy, you may get a number of different side effects. There are lots of things that can be done to help prevent or relieve these. Do let people know how you are feeling and ask questions if you don’t know what is happening. Your hospital team will be there to support you through your treatment.

The most common side effects of the kind of chemotherapy usually used for Burkitt’s lymphoma include:

Ø  low blood counts, causing

o   Neutropenia (low white blood cells), making you much more prone to infections – your hospital team need to know at once if you have any signs of infection

o   Anaemia, making you short of breath or very tired – a blood transfusion may help

o   Low platelets, making you more likely to bleed or bruise very easily – you may need platelet transfusions to help stop you bleeding or to reduce the risk

Ø  Sore mouth (mucositis) or mouth ulcers – using mouthwashes regularly can help

Ø  Feeling sick or having diarrhea

Ø  Temporary hair loss – usually starting a couple of weeks after chemotherapy has begun and growing back from a month or two after it finishes

Ø  Fatigue

Ø  Peripheral neuropathy (damage to nerves, especially in the hands and feet), causing symptoms such as pins and needles, pain and numbness.

Ø  Long-terms side effects (late effects) that might affect you include:

Ø  Reduced fertility

Ø  An increased risk of second cancers

Ø  Heart disease.

Your doctors will discuss with you what your risks are and what can be done to help.

What happens if Burkitt’s lymphoma comes back?

If your lymphoma is not in complete remission after your treatment or if it comes back later (relapses), your doctors may offer you further treatment. What can be offered will depend on:

Ø  what your previous treatment was

Ø  how well you coped with your previous treatment

Ø  whether you are fit enough for more intensive treatments, which might include

o   High-dose ‘salvage’ chemotherapy, which is different from the first treatment you had

o   A stem cell transplant once your lymphoma has responded again to chemotherapy

o   Your thoughts about further treatment – your doctors and hospital team will help you to decide what is best for you.

Less common types of Burkitt’s lymphoma

Intermediate type

Sometimes a lymphoma appears to be like Burkitt’s lymphoma in some ways and like diffuse large B-cell lymphoma (DLBCL) in other ways. For example the lymphoma might look like a Burkitt’s lymphoma under the microscope but not have the usual change in the MYC gene. The official name doctors give these is ‘B-cell lymphoma, unclassified, with features intermediate between DLBCL and Burkitt’s lymphoma’.

Some of these lymphomas will also have another change in their genes and are known as ‘double-hit’ lymphomas.

These lymphomas are not common. Often they will be treated in the same way as typical Burkitt’s lymphoma.

HIV-associated Burkitt’s lymphoma

Lymphomas are more common in people with HIV infection. Burkitt’s lymphoma makes up around 1 in 6 of the lymphomas seen in people with HIV. It can occur before the HIV infection starts to cause much immunodeficiency (weakening of the immune system).

Treating lymphoma in people with HIV carries more risk of complications, particularly infections. However, if the same chemotherapy can be tolerated, it often works just as well.  In addition, a recent trial using a form of DA-EPOCH-R chemotherapy, with a slightly lower dose for people with Burkitt’s lymphoma and HIV infection, has reported promising results.

Thank you