About Burkitt’s lymphoma
Burkitt’s Lymphoma can begin in different parts of the body.
- If it starts in your lymph nodes (small glands that help fight infection), it’s called “nodal.”
- If it starts outside the lymph nodes — like in your organs or bone marrow — it’s called “extra-nodal.”
There are three types of Burkitt’s lymphoma
- Endemic Burkitt’s lymphoma
- Sporadic Burkitt’s lymphoma
- Immunodeficiency-related Burkitt’s lymphoma
Burkitt’s lymphoma:
Accounts for 1% of adult lymphomas.
Accounts for 30% of childhood NHLs, affecting those between 5-10 years old.
Most commonly diagnosed in adults aged 30-50 years old.
Causes of Burkitt’s lymphoma
There is no specific cause of Burkitt’s lymphoma. There are links between genetic changes in a gene called MYC, which helps control cell growth, and exposure to some viruses. There are also other factors that can increase your risk of developing Burkitt’s lymphoma.
These include:
- Previous exposure to Epstein Barr virus (EBV)
- Age – more common in children and young adults
- Gender – It is 4 times more likely in men than women
- Geography – Burkitt’s lymphoma is more prevalent in areas where malaria is present
- Immunodeficiency with medicines or from a virus such as HIV
- A family history of lymphoma
Symptoms of Burkitt’s lymphoma
Burkitt’s lymphoma is a fast-growing form of blood cancer. This means that symptoms can appear suddenly and get worse quickly.
Some of the most common symptoms include:
- Painless swelling in the neck, armpit or groin
- Abdominal pain or feeling full for no reason
- Nausea or vomiting
- Fevers without infection
- Tired for no reason
- Drenching night sweats
- Weight loss without trying
- Confusion or memory changes
Diagnosis of Burkitt’s lymphoma
Burkitt’s lymphoma is diagnosed with a number of tests. You may have some or all of these tests before an accurate diagnosis can be made.
Lymph node biopsy
The best test to diagnose Burkitt’s lymphoma is a lymph node biopsy. A lymph node biopsy is a procedure that involves taking a sample of tissue from a swollen lymph node and examining it under the microscope. If you have multiple swollen lymph nodes, you will only have a biopsy of one of them.
Other tests you will have include:
- Medical history and physical exam
- Blood tests – full blood count (FBC), kidney and liver function, electrolytes
- Genetic tests
These tests help your treatment team work out how far the disease has spread and what other organs it might be affecting. Staging helps determine prognosis and treatment. These tests include:
- Computed tomography (CT) scan
- Positron emission tomography (PET) scan
- Bone marrow biopsy
- Lumbar puncture
Staging Burkitt’s lymphoma
Staging refers to how far the lymphoma has spread throughout your body. It is possible for B-cells to travel anywhere in the body. This also means the lymphoma cells can travel anywhere in the body. There are 4 stages of Burkitt’s lymphoma. Stage 1 and 2 are early-stage disease, and stage 3 and 4 are advanced disease. It is often diagnosed at stage 3 or 4 because it is an aggressive fast-growing blood cancer.
| Stage 1 One lymph node area is affected, either above or below the diaphragm | Stage 2 Two or more lymph node areas are affected on the same side of the diaphragm |
| Stage 3 At least one lymph node area above and at least one lymph node area below the diaphragm | Stage 4 Lymphoma is in multiple nodes and has spread to other parts of the body (eg. bones, lungs, liver) |
The diaphragm is a thin, dome-shaped muscle that sits under your lungs and above your stomach.
Types of Burkitt’s lymphoma
The World Health Organization (WHO) classifies Burkitt’s lymphoma into 3 subtypes:
Endemic Burkitt’s lymphoma
- Most common inpart of Africa and is link to Epstein-Barr virus (EBV)
Sporadic Burkitt’s lymphoma
- Commonly found in people of European descent. It makes up around 30% of childhood NHL cases
Immunodeficiency-related Burkitt’s lymphoma
- Affects people with weakened immune systems, such as those with HIV
Prognosis of Burkitt’s lymphoma
A prognosis is an estimate your haematologist will make of the likely course and outcome of your disease. With prompt treatment, Burkitt’s lymphoma is often curable.
Many factors will be considered when discussing your prognosis. Some of these are:
- Your subtype and stage of Burkitt’s lymphoma
- Your overall health
- Your age
- Whether the lymphoma has spread to the central nervous system (CNS)
Your prognosis might change if your Burkitt’s lymphoma comes back after treatment or responds poorly to treatment.
Fertility
Treatments for Burkitt’s lymphoma can affect fertility. For women some treatments can cause damage to the ovaries. For men it is possible to have low or abnormal sperm production. Your fertility may become normal again in the future, but it is difficult to predict.
It is important to ask your doctor about your risk of infertility as early as possible. There are some options for preserving fertility. Decisions about what options might be right for you usually need to be made before you start treatment.
For more information go to: Fertility support.
Treatment of Burkitt’s lymphoma
You will need to start treatment for your Burkitt’s lymphoma soon after your diagnosis. It can progress quickly if left untreated.
Your haematologist will consider many factors when deciding on a treatment plan for you. These might include:
- Your subtype and stage of Burkitt’s lymphoma
- Your overall health
- Your age
- Whether the lymphoma has spread to the central nervous system (CNS)
Treatment normally includes chemotherapy, immunotherapy, and steroids. A stem cell transplant may be an option for you if you have relapsed or hard to treat disease (refractory). If the lymphoma has spread to the CNS, you will need to have lumbar punctures to treat it. Some people may also need radiotherapy.
The treatment for Burkitt’s lymphoma is strong and complex. You will need to stay in the hospital during treatment and while you recover. Information on some types of treatments used for Burkitt’s lymphoma can be found here. You will need to be monitored closely as you may experience side effects from the chemotherapy and immunotherapy.
The different chemotherapy regimens can be explored here: Burkitt lymphoma | eviQ
Immunotherapy for Burkitt’s lymphoma
Immunotherapy is a type of biological therapy. It uses the immune system to recognise cancer cells and destroy them. Immunotherapy for Burkitt’s lymphoma is given intravenously (IV). Immunotherapy works by:
- Stimulating the immune system to find and attack cancer cells
- Removes barriers that are preventing the immune system from killing cancer cells
Monoclonal antibodies are a type of immunotherapy. For people with Burkitt’s lymphoma, they are often given in combination with chemotherapy.
Monoclonal anti-CD20 antibody:
Rituximab is anexample of monoclonal anti-CD20 antibodies.
- CD20 is a protein found on the surface of B-cells
- This is termed CD20 positive
- The monoclonal anti-CD20 antibody connects to this protein on the blood cancer cell
- It destroys the cell by damaging the antibody, causing the cell to die
Follow-up care
You will need regular checkups with your treatment team once you have finished treatment for your Burkitt’s lymphoma. This is to check on long term side effects from treatment. You will also need to have tests and scans to make sure the lymphoma hasn’t come back (relapsed/recurred). It is possible you may require more treatment to keep the lymphoma under control if it returns.
Living with Burkitt’s lymphoma
How Burkitt’s lymphoma affects your everyday life will depend on many factors. It could be that you are returning or managing work, trying to exercise or managing your nutrition. There are some helpful resources and information to guide you – Living well with blood cancer. The Online Blood Cancer Support Service has learn modules on long term side effects, transition to the new normal, cancer related fatigue and more.
Caring for someone with Burkitt’s lymphoma
We have a range of information and resources that may help when you are caring for someone with Burkitt’s lymphoma.
