Burkitt's Lymphoma

Burkitt’s lymphoma is a rare and aggressive form of non-Hodgkin lymphoma. Non-Hodgkin lymphoma is a type of cancer of the lymphatic system, which helps your body fight infections.

Burkitt’s lymphoma is most common in children living in sub-Saharan Africa, where it’s related to the Epstein-Barr virus (EBV) and chronic malaria. Burkitt’s lymphoma is also seen elsewhere, including the United States. Outside of Africa, Burkitt’s lymphoma is most likely to occur in people who have a compromised immune system.

Symptoms

What Are the Symptoms of Burkitt’s Lymphoma?

Burkitt’s lymphoma can cause fever, weight loss, and night sweats. Other symptoms of Burkitt’s lymphoma vary according to type.

Sporadic Burkitt’s Lymphoma

The symptoms of sporadic Burkitt’s lymphoma include:

• abdominal swelling
• distortion of facial bones
• night sweats
• intestinal obstruction
• an enlarged thyroid
• enlarged tonsils

Endemic Burkitt’s Lymphoma

The symptoms of endemic Burkitt’s lymphoma include swelling and distortion of facial bones and a rapid growth of lymph nodes. The enlarged lymph nodes are non-tender. Tumors can grow extremely quickly, sometimes doubling their size within 18 hours.

HIV-Related Lymphoma

The symptoms of HIV-related lymphoma are similar to those of the sporadic type.

Causes

What Causes Burkitt’s Lymphoma?

The exact cause of Burkitt’s lymphoma is unknown. Risk factors vary according to geographic location. Studies suggest that Burkitt’s lymphoma is the most common childhood cancer in regions where there is a high incidence of malaria, like Africa. Elsewhere, the greatest risk factors are HIV and AIDS.

What Are the Types of Burkitt’s Lymphoma?

There three types of Burkitt’s lymphoma are sporadic, endemic, and immunodeficiency-related. The types differ with by geographic location and the parts of the body that are affected.

Sporadic Burkitt’s Lymphoma

Sporadic Burkitt’s lymphoma does occur outside of Africa, but it’s rare in the other parts of the world. It’s sometimes associated with EBV. It tends to affect the lower abdomen, where the small intestine ends and the large intestine begins.

Endemic Burkitt’s Lymphoma

This type of Burkitt’s lymphoma is most often seen in Africa near the equator, where it’s associated with chronic malaria and EBV infection. The facial bone and jaw are most often affected. But the small intestine, kidneys, ovaries, and breast may also be involved.

Immunodeficiency-Related

This type of Burkitt’s lymphoma is associated with the use of immunosuppressive drugs like those used to prevent transplant rejection and to treat HIV and AIDS.

Risk Factors

Who Is at Risk for Burkitt’s Lymphoma?

Burkitt’s lymphoma is most likely to affect children. It’s rare in adults. The disease is more common in males and people with compromised immune systems, like those who have HIV or AIDS. The incidence is higher in:

• North Africa
• the Middle East
• South America
• Papua New Guinea

Sporadic and endemic forms are associated with EBV infection. Insect-borne viral infections and herbal extracts that promote tumor growth are possible contributing factors.

Diagnosis

How Is Burkitt’s Lymphoma Diagnosed?

A diagnosis of Burkitt’s lymphoma begins with a medical history and physical examination. A biopsy of tumors confirms the diagnosis. The bone marrow and central nervous system are often involved. Bone marrow and spinal fluid are usually examined to see how far the cancer has spread.
Burkitt’s lymphoma is staged according to lymph node and organ involvement. The involvement of bone marrow or the central nervous system means you have stage 4. A CT scan and MRI can help pinpoint which organs and lymph nodes are involved.

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Treatment

How Is Burkitt’s Lymphoma Treated?

Burkitt’s lymphoma is usually treated with combination chemotherapy. Chemotherapy agents used in the treatment of Burkitt’s lymphoma include:

• cytarabine
• cyclophosphamide
• doxorubicin
• vincristine
• methotrexate
• etoposide

Monoclonal antibody treatment with rituximab may be combined with chemotherapy. Radiation treatment may also be used with chemotherapy.
Chemotherapy drugs are injected directly into the spinal fluid to prevent the cancer from spreading to the central nervous system. This method of injection is referred to as “intrathecal.” Patients who get intensive chemotherapy have the best treatment outcomes.
In countries with limited medical resources, treatment is often less aggressive and less successful. Children with Burkitt’s lymphoma have the best prognosis. The presence of intestinal obstruction requires surgery.

Outlook

What Is the Long-Term Outlook?

The outcome depends on the stage at diagnosis. The outlook is often worse in adults over age 40, but treatment for adults has improved in recent years. The outlook is poor in people who have HIV or AIDS. It’s significantly better in people whose cancer hasn’t spread