Burkitt Lymphoma

Burkitt lymphoma explained briefly

Burkitt lymphoma is a very aggressive form of blood cancer that belongs to the . It develops from , a type of white blood cell that is part of the immune system. In Burkitt lymphoma, these cells multiply uncontrollably and spread quickly to the lymph nodes, blood, bone marrow and other organs.

What exactly is Burkitt lymphoma?

Burkitt lymphoma is characterised by a genetic change that leads to overactivity of the so-called MYC gene. This drives the cancer cells to divide very rapidly. There are three subtypes:

  • Endemic Burkitt lymphoma: Mainly found in African regions, often associated with an Epstein-Barr virus infection.
  • Sporadic Burkitt lymphoma: Occurring worldwide, mostly in Western countries.
  • Immunodeficiency-associated Burkitt lymphoma: Often occurs in people with a weakened immune system, e.g. in HIV infections.

Why do I have Burkitt lymphoma?

The causes of Burkitt lymphoma are not fully understood, but there are certain risk factors:

  • Epstein-Barr virus (EBV): The virus plays a role above all in the endemic form.
  • Immune deficiency: A weakened immune system, e.g. due to HIV, increases the risk.
  • Genetic changes: The MYC gene is a central factor in the development of the disease.
  • Geographic and environmental factors: In some regions of Africa, children are particularly affected, possibly due to co-infections with malaria.

Symptoms of Burkitt lymphoma

Because Burkitt lymphoma is very aggressive, the symptoms often appear quickly and clearly:

  • Severely swollen lymph nodes (often in the abdomen or neck area)
  • Pain and swelling in the abdomen
  • Weight loss and loss of appetite
  • Fever and night sweats
  • Tiredness and weakness
  • In rare cases bone pain or neurological deficits when the nervous system is affected

When is Burkitt lymphoma treated?

Because of its rapid growth, Burkitt lymphoma requires immediate treatment. Starting therapy early is crucial in order to contain the spread of the disease and improve the chances of a cure.

How is Burkitt lymphoma treated?

The treatment of Burkitt lymphoma is intensive and is based on a combination of chemotherapy and supportive measures:

  • Intensive chemotherapy: In Germany, Burkitt lymphoma is treated according to the GMALL-B-ALL/NHL2002 protocol. This protocol combines intensive chemotherapy with the rituximab. The therapy comprises several cycles of intensive chemotherapy, including agents such as cyclophosphamide, doxorubicin, vincristine, methotrexate and cytarabine, supplemented by rituximab. The protocol also includes preventive measures against cancer cells entering the central nervous system.
  • Immunotherapy: Rituximab is often used to supplement chemotherapy.
  • Targeted therapies: Although not yet established as standard, studies on CAR-T cell therapies in Burkitt lymphoma are currently ongoing (Zuma-25).
  • Supportive therapy: Accompanying measures such as transfusions, infection prophylaxis and nutritional therapy are important.

How exactly have clinical trials changed the treatment landscape in Burkitt lymphoma?

The German Multicenter Study Group for Adult ALL (GMALL) is an academic study group that has been investigating the treatment of ALL and Burkitt lymphoma in trials for 40 years. With regard to Burkitt lymphoma, the GMALL-B-ALL/NHL2002 trial investigated the treatment of Burkitt lymphoma in adults in one of the largest prospective multicentre studies. It shows that a combination of intensive chemotherapy and rituximab achieves high cure rates. Among 363 patients, the complete was 88 %, and the 5-year survival rate was 80 %. Older patients (over 55 years) received a reduced treatment protocol that was less intensive but still effective. The most important prognostic factors were age, the International Prognostic Index (IPI) and sex-specific differences. The study highlights that rituximab improves survival rates and that new approaches, such as targeted therapies, could further optimise future treatment strategies.

Hoelzer D, Walewski J, Döhner H, et al. Improved outcome of adult Burkitt lymphoma/leukemia with rituximab and chemotherapy: report of a large prospective multicenter trial. Blood. 2014;124(26):3870-3879. DOI: 10.1182/blood-2014-03-563627

This information is not a substitute for a conversation with your doctor.