burkitt like lymphoma |Burkitt's lymphoma

Burkitt's lymphoma


Burkitt's lymphoma is a type of mature B-cell non-Hodgkin's lymphoma (NHL). Burkitt lymphoma appears most often in children or young adults and rarely in older adults. It affects boys more. Epstein-Barr virus (EBV) is a known risk factor, and most people diagnosed with Burkitt lymphoma are infected with this virus.

Burkitt's lymphoma is a type of NHL that evolves very quickly (aggressive). It tends to appear in organs or tissues other than the lymph nodes (extraganglionnaires seats) and often spreads to the brain or spinal cord (central nervous system).

Burkitt lymphoma can affect the bone marrow so that it does not function normally. Blastic cells therefore do not ripen properly, and these abnormal immature blood cells, called Burkitt lymphoma cells, are found in the bloodstream. If more than 25% of the cells present in the bone marrow are Burkitt lymphoma cells, doctors can classify it as acute lymphoblastic leukemia (LAL), L3 or Burkitt leukemia.

There is also a Burkitt type lymphoma. When Burkitt-type lymphoma cells are observed under a microscope, they differ somewhat from Burkitt lymphoma cells. They also possess cell characteristics of large B-cell diffuse lymphoma (LDGCB). Burkitt-type lymphoma is classified among Burkitt lymphomas.

Burkitt lymphoma subtypes
There are 3 subtypes of Burkitt lymphoma.

Endemic Burkitt lymphoma is also referred to as African Burkitt lymphoma, as it is mainly manifested in Africa. It is almost always associated with Epstein-Barr virus infection. It is used to appear first in the form of a tumor in the jaw or in another bone of the face.

Sporadic Burkitt lymphoma is also referred to as non-African or non-endemic Burkitt lymphoma. It is the most common type of Burkitt lymphoma in North America and Europe. It is sometimes associated with Epstein-Barr virus, but many people with sporadic Burkitt lymphoma are not infected with this virus. This type of NHL usually takes birth in the form of a tumor in the abdomen, but it can also do so in the ovaries, testicles, kidneys or other organs. It is possible that it will spread to the CNS.

Burkitt lymphoma linked to immunodeficiency tends to manifest in people with weakened immune systems, usually those with HIV infection. It is not usually associated with Epstein-Barr virus. The number of Burkitt lymphoma cases associated with immunodeficiency appears to be declining as antiretroviral therapy is used to treat HIV. 

Treatments

Chemotherapy is the primary treatment of Burkitt's lymphoma.  Targeted treatment and CNS prophylaxis can also be administered.

Chemotherapy

Associations of the following chemotherapeutic agents may be used to treat Burkitt's lymphoma:

CODOX-M – Cyclophosphamide (Cytoxan, Procytox), vincristine (Oncovin), doxorubicin (Adriamycin) and high dose methotrexate

CODOX-M/VCI (Magrath Protocol) – CODOX-M and VCI, consisting of ifosfamide (Ifex), etoposide (Vepesid) and Cytarabine (Cytosar, Ara-C)

Hyper-CVAD – cyclophosphamide, vincristine, doxorubicin, Dexamethasone (Decadron, Dexasone), methotrexate and Cytarabine

EPOCH – Etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin

Tumor lysis syndrome (SLT) is a set of side effects that occur when a large number of lymphoma cells are destroyed in a short period of time. It often appears when administering chemotherapy for Burkitt lymphoma, so the care team takes the necessary steps to prevent SLT before chemotherapy. Learn more about tumor lysis syndrome.

Targeted treatment

Targeted treatment uses drugs to target specific molecules (such as proteins) located on the surface of cancer cells. These molecules contribute to the sending of signals that tell cells to grow or divide. By targeting these molecules, medications interrupt the growth and spread of cancer cells while limiting damage to normal cells.

Rituximab (Rituxan) is the most commonly used targeted drug for treating Burkitt lymphoma. It can be added to one of the chemotherapy associations mentioned above.

Central nervous system prophylaxis

CNS prophylaxis is being done to try to prevent lymphoma cells from penetrating the tissue that covers the brain and spinal cord.

Methotrexate and cytarabine are used for CNS prophylaxis. They are administered by intrathecal chemotherapy, i.e. injected into the cerebrospinal fluid (CSF).

High doses of methotrexate are also administered for CNS prophylaxis. It is administered by a needle inserted in a vein (intravenous).