Burkitt’s lymphoma is a relatively rare and aggressive form of non-Hodgkin’s lymphoma. Non-Hodgkin’s lymphoma is a type of cancer of the lymphatic system. The lymphatic system helps your body to fight infections.
Burkitt’s lymphoma is most common in children living in sub-Saharan Africa, where it is related to the Epstein-Barr virus (EBV) and chronic malaria. Burkitt’s lymphoma is also seen elsewhere, including the U.S. Outside of Africa, Burkitt’s lymphoma is most likely to occur in people who have a compromised immune system.
The exact cause of Burkitt’s lymphoma is not known. Risk factors vary according to geographic location. According to The Lancet, Burkitt’s lymphoma is the most common childhood cancer in regions where there is a high incidence of malaria, such as Africa. Elsewhere, the greatest risk factor is HIV/AIDS.
There are three types of Burkitt’s lymphoma: 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 occurs outside of Africa, but is rare in the developed world. It is 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 equatorial Africa, where it is associated with chronic malaria and EBV infection. The facial bone and jaw is most often affected. But the small intestine, kidneys, ovaries, and breast may also be involved.
This type of Burkitt’s lymphoma is associated with the use of immunosuppressive drugs such as those that used to prevent transplant rejection, and in the treatment of HIV/AIDS.
Burkitt’s lymphoma is most likely to affect children. It is rare in adults. The disease is more common in males and people with compromised immune systems, such as those with HIV/AIDS. The incidence is higher in North Africa, the Middle East, South America, and 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.
Symptoms of Sporadic Burkitt’s Lymphoma
Symptoms of sporadic Burkitt’s lymphoma include:
- abdominal pain and swelling (ascites)
- involvement (including distortion) of facial bones
- intestinal obstruction
- enlarged thyroid
- enlarged tonsils
Symptoms of Endemic Burkitt’s Lymphoma
Symptoms of endemic Burkitt’s lymphoma include:
- swelling and distortion of facial bones
- rapid increase in the size of lymph nodes (enlarged lymph nodes are non-tender)
- tumors can grow extremely quickly, sometimes doubling their size within 18 hours
Symtoms for HIV-related lymphoma are similar to those of the sporadic type.
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.
Burkitt’s lymphoma is usually treated with combination chemotherapy. Chemotherapy agents used in the treatment of Burkitt’s lymphoma are:
Monoclonal antibody treatment with rituximab may be combined with chemotherapy.
Chemotherapy is injected directly into the spinal fluid (intrathecal) to prevent the cancer from spreading to the central nervous system. Patients who get intensive chemotherapy have the best treatment outcomes.
In developing nations, treatment is often less aggressive and less successful. Children with Burkitt’s lymphoma have the best prognosis. The presence of intestinal obstruction requires surgery.
The outcome depends on the stage at diagnosis. It is often worse for adults over age 40, though treatment for adults has improved in recent years. The prognosis is poor in people who have HIV/AIDS. It is significantly better in people whose cancer has not spread.