All About Burkitt’s Lymphoma

Burkitt's Lymphoma is an uncommon form of the non-Hodgkin's lymphoma that usually affects children. It is an aggressive type of cancer tumor that starts in the immune cells called B-cells. Despite its fast-growing and fast-spreading nature, it can be cured with intensive chemotherapy. This condition is named after Denis Burkitt, a British surgeon who identified this disease in 1956 among African children. At that time, Burkitt's lymphoma was found to be prevalent among young children who had malaria and Epstein-Barr. About 98 percent of African cases were linked with the Epstein-Barr infection.

Types
There are two types of this lymphoma: endemic and sporadic.

Endemic Burkitt's Lymphoma refers to the one that primarily affects children from Africa, usually between the ages of 4 and 7 years old. This is twice more common in boys than girls.

Sporadic Burkitt's Lymphoma is the type that occurs in other parts of the world. In the United States and Western Europe, it accounts for almost half of the pediatric lymphoma cases.

The link between the Epstein-Barr infection and the Burkitt's Lymphoma is stronger in the endemic cases than sporadic cases.

Symptoms
Burkitt's lymphoma symptoms depend on the type.

- The first type, the endemic variant, commonly begins as tumors in the jaw and facial bones. It can also develop in the ovaries, breasts, and gastrointestinal tract. The tumors may spread to the central nervous system, damage the nerves, and cause weakness and paralysis.

- For the sporadic type, the tumors begin as a bulky mass of tumor in the abdomen that involves the liver, spleen and bone marrow. It may also develop in the ovaries and testes, then spread to the brain and spinal fluid.

Common symptoms in general include:
- fatigue
- weight loss
- night sweats
- loss of appetite
- unexplained fever

Diagnosis
Since this type of lymphoma is very aggressive, it's imperative to have it diagnosed early for immediate treatment.

- biopsy
Biopsy will be done on the enlarged lymph node or other suspected disease site. In this process, a sample tissue is taken to be examined under a microscope. This will confirm the presence or absence of Burkitt's lymphoma.

Other tests that may be performed are:
- chest X-ray
- bone marrow biopsy
- PET or gallium scan
- and HIV disease testing
- examination of the spinal fluid
- CT scan of the chest, abdomen, and pelvis
- blood tests for the kidney and liver function

Treatments

Intrathecal Chemotherapy
The preferred treatment for this cancer is intensive intravenous chemotherapy. This usually requires hospital stay throughout the treatment. This is preferred by doctors since this form of cancer can easily spread to the fluid that surrounds the spinal cord and brain. Chemotherapy drugs will be injected directly into the cerebrospinal fluid. This treatment method is called intrathecal chemotherapy.
There are only three agents licensed to be used in intrathecal chemotherapy:
- methotrexate (Rheumatrex)
- cytarabine (Cytosar-U, Tarabine PFS)
- hydrocortisone (Locoid, Westcort)

Non-Intrathecal Chemotherapy
Other chemotherapeutic drugs for non-intrathecal treatment include:
- vincristine (Oncovin)
- doxorubicin (Adriamycin)
- cyclophosphamide (Cytoxan)
- etoposide (Etopophos, Toposar, VePesid)

Other Treatments
Other treatment methods are:
- steroid therapy
- radiation therapy
- autologous stem cell transplantation

- surgery
Surgery may also be performed to remove intestine parts that are blocked or have ruptured.

 


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