Burkitt Lymphoma

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This blog is for informational purposes only and should not be taken as medical advice. Content is sourced from third parties, and we do not guarantee accuracy or accept any liability for its use. Always consult a qualified healthcare professional for medical guidance.

What is Burkitt Lymphoma?

Burkitt lymphoma is a rare, highly aggressive B-cell non-Hodgkin lymphoma characterized by rapid tumor growth and spread, often affecting extranodal sites like the jaw, abdomen (bowel, kidneys), ovaries, bones, or central nervous system. It has three variants: endemic (EBV-associated, common in African children, affecting jaw), sporadic (worldwide, abdominal focus), and immunodeficiency-related (AIDS-associated). It accounts for 1-2% of adult lymphomas and 30-40% of pediatric non-Hodgkin lymphomas, with approximately 1,500 US cases annually in 2025. It is also known as diffuse small non-cleaved-cell lymphoma due to its microscopic appearance.

Symptoms

Symptoms depend on tumor location and rapid growth, including painless, rapidly enlarging lymph nodes (neck, groin, axilla), B symptoms (fever, night sweats, unexplained weight loss >10% in 6 months), abdominal pain/swelling (from bowel or organ involvement), nausea, vomiting, or bowel obstruction (in abdominal cases). Endemic cases often present with jaw/facial masses. CNS involvement causes headaches, seizures, or cranial nerve deficits. Bone marrow involvement leads to fatigue, anemia, or bleeding. Symptoms progress quickly, often within weeks, necessitating urgent evaluation.

Causes

Burkitt lymphoma is driven by chromosomal translocations, primarily t(8;14), activating the MYC oncogene in 80-90% of cases, leading to uncontrolled B-cell proliferation. Epstein-Barr virus (EBV) is strongly linked to endemic (90-95%) and some sporadic/immunodeficiency-related cases, promoting oncogenesis in genetically susceptible individuals. Risk factors include immunosuppression (HIV/AIDS, post-transplant), malaria (in endemic areas, enhancing EBV effects), and genetic predisposition (rare familial cases). In 2025, research highlights epigenetic changes (e.g., histone modifications) and immune evasion as key drivers, with no strong lifestyle links.

Diagnosis

Diagnosis involves a comprehensive workup: CBC shows anemia or thrombocytopenia, with elevated lactate dehydrogenase (LDH) indicating tumor burden. Blood tests screen for hepatitis, HIV, and renal function. Imaging (CT, PET, MRI) assesses tumor extent and organ involvement. Bone marrow aspiration/biopsy and lymph node biopsy confirm diagnosis, with immunohistochemistry (CD20+, MYC+, Ki-67 >95%) and fluorescence in situ hybridization (FISH) detecting MYC translocations. Lumbar puncture evaluates CNS involvement. In 2025, NGS refines subtype classification, and AI-assisted pathology improves diagnostic speed by 20%.

Treatment

Treatment requires intensive, multi-agent chemotherapy due to rapid tumor doubling time (24-48 hours), often using regimens like CODOX-M/IVAC (cyclophosphamide, vincristine, doxorubicin, methotrexate, ifosfamide, etoposide, cytarabine) or hyper-CVAD with rituximab (anti-CD20 monoclonal antibody). CNS prophylaxis (intrathecal methotrexate) prevents relapse. High-risk or relapsed cases may require autologous/allogeneic stem cell transplant. Supportive care (tumor lysis syndrome prophylaxis, antibiotics) is critical. In 2025, novel agents like devimistat (CPI-613, targeting mitochondrial metabolism) achieve complete remissions in 20-30% of heavily pre-treated patients, and bispecific antibodies (e.g., mosunetuzumab) show promise in trials.

Future Outlook

In 2025, Burkitt lymphoma’s 5-year survival is 50-90%, with children achieving 80-90% and adults 50-70%, depending on stage and HIV status. Rituximab + chemotherapy improves complete response rates to 70-80%, and devimistat enhances outcomes in relapsed cases. Research focuses on epigenetic therapies (e.g., EZH2 inhibitors), CAR-T cells, and immune checkpoint inhibitors to overcome MYC-driven resistance. By 2030, these could increase overall survival to 80% and relapsed survival to 50%, with emphasis on reducing treatment toxicity and improving access in endemic regions.

Sources

The information for Burkitt lymphoma is sourced from the National Cancer Institute’s “Non-Hodgkin Lymphoma Treatment (PDQ®)” for comprehensive details on understanding, symptoms, causes, diagnosis, and treatment; ASH Publications’ “Novel Devimistat Results in Complete Remissions in Heavily Pre-Treated Burkitt Lymphoma” for outcomes with novel agents; The Lancet’s “Diagnosis and treatment of Burkitt lymphoma in adults” for management strategies and prognosis; ASCO’s “Effectiveness of rituximab plus chemotherapy in pediatric Burkitt lymphoma” for rituximab-based therapy insights; and Nature’s “Outcomes and prognostic factors in patients with Burkitt lymphoma” for survival and prognostic factor analysis.