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Burkitt’s and Burkitt-like Lymphoma

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Burkitt’s and Burkitt-like lymphoma (BL/BLL) are aggressive B-cell malignancies with a high proliferative rate that may be fatal within months if not treated promptly. Furthermore, treatment of BL/BLL requires comprehensive supportive care to avoid disease-related complications such as acute renal failure secondary to tumor lysis syndrome. Improvements in our understanding of the biology of BL and BLL have led to more effective therapeutic protocols. Clinical trials have demonstrated that short duration, multi-agent, dose-intensive chemotherapy regimens combined with aggressive central nervous system therapy results in long-term survival rates in children and young adults near 70% to 80%, whereas long-term disease-free survival rates in older adults remains suboptimal at 15% to 25%. Outcomes in HIV-associated BL/BLL are improved because of more effective chemotherapy regimens and enhanced HIV care. Autologous bone marrow transplantation has proven feasible in many patient populations with BL/BLL and may lead to cure in selected patients. Improved therapeutic strategies are warranted, such as integrating agents such as monoclonal antibodies to combination dose-intensive chemotherapy. Moreover, further study into the molecular biology of BL/BLL with attention to the role of c-myc dysregulation is needed to help predict prognostic factors and for the development of molecular targeted therapies. Clinical trials remain critical to determine the most effective treatment regimens that will continue to improve cure rates in this aggressive but treatable disease.

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References and Recommended Reading

  1. Lee EJ, Petroni GR, Schiffer CA, et al.: Brief-duration high-intensity chemotherapy for patients with small noncleaved-cell lymphoma or FAB L3 acute lymphocytic leukemia: results of cancer and leukemia group B study 9251. J Clin Oncol 2001, 19:4014–4022.

    PubMed  CAS  Google Scholar 

  2. Magrath I, Adde M, Shad A, et al.: Adults and children with small non-cleaved-cell lymphoma have a similar excellent outcome when treated with the same chemotherapy regimen. J Clin Oncol 1996, 14:925–934.

    PubMed  CAS  Google Scholar 

  3. Adde M, Shad A, Venzon D, et al.: Additional chemotherapy agents improve treatment outcome for children and adults with advanced B-cell lymphomas. Semin Oncol 1998, 25:33–39.

    PubMed  CAS  Google Scholar 

  4. Patte C, Auperin A, Michon J, et al.: The Societe Francaise d’Oncologie Pediatrique LMB89 protocol: highly effective multiagent chemotherapy tailored to the tumor burden and initial response in 561 unselected children with B-cell lymphomas and L3 leukemia. Blood 2001, 97:3370–3379.

    Article  PubMed  CAS  Google Scholar 

  5. Kantarjian HM, O’Brien S, Smith TL, et al.: Results of treatment with hyper-CVAD, a dose-intensive regimen, in adult acute lymphocytic leukemia. J Clin Oncol 2000, 18:547–561.

    PubMed  CAS  Google Scholar 

  6. Larson RA, Dodge RK, Burns CP, et al.: A five-drug remission induction regimen with intensive consolidation for adults with acute lymphoblastic leukemia: cancer and leukemia group B study 8811. Blood 1995, 85:2025–2037.

    PubMed  CAS  Google Scholar 

  7. Fenaux P, Bourhis JH, Ribrag V: Burkitt’s acute lymphocytic leukemia (L3ALL) in adults. Hematol Oncol Clin North Am 2001, 15:37–50.

    Article  PubMed  CAS  Google Scholar 

  8. Harris NL, Jaffe ES, Stein H, et al.: A revised European- American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood 1994, 84:1361–1392.

    PubMed  CAS  Google Scholar 

  9. Harris NL, Jaffe ES, Diebold J, et al.: World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting—Airlie House, Virginia, November 1997. J Clin Oncol 1999, 17:3835–3849.

    PubMed  CAS  Google Scholar 

  10. Braziel RM, Arber DA, Slovak ML, et al.: The Burkitt-like lymphomas: a Southwest Oncology Group study delineating phenotypic, genotypic, and clinical features. Blood 2001, 97:3713–3720.

    Article  PubMed  CAS  Google Scholar 

  11. Wright DH: What is Burkitt’s lymphoma and when is it endemic? Blood 1999, 93:758.

    PubMed  CAS  Google Scholar 

  12. Hecht JL, Aster JC: Molecular biology of Burkitt’s lymphoma. J Clin Oncol 2000, 18:3707–3721.

    PubMed  CAS  Google Scholar 

  13. Ziegler JL: Chemotherapy of Burkitt’s lymphoma. Cancer 1972, 30:1534–1540.

    Article  PubMed  CAS  Google Scholar 

  14. Ziegler JL: Treatment results of 54 American patients with Burkitt’s lymphoma are similar to the African experience. N Engl J Med 1977, 297:75–80.

    Article  PubMed  CAS  Google Scholar 

  15. Bowman WP, Shuster JJ, Cook B, et al.: Improved survival for children with B-cell acute lymphoblastic leukemia and stage IV small noncleaved-cell lymphoma: a pediatric oncology group study. J Clin Oncol 1996, 14:1252–1261.

    PubMed  CAS  Google Scholar 

  16. Lerede T, Bassan R, Rossi A, et al.: Therapeutic impact of adult-type acute lymphoblastic leukemia regimens in B-cell/L3 acute leukemia and advanced-stage Burkitt’s lymphoma. Haematologica 1996, 81:442–449.

    PubMed  CAS  Google Scholar 

  17. Clarkson BD, Gee T, Arlin ZA, et al.: Current status of treatment of acute leukemia in adults: an overview of the Memorial experience and review of literature. Crit Rev Oncol Hematol 1986, 4:221–248.

    PubMed  CAS  Google Scholar 

  18. Hoelzer D, Ludwig WD, Thiel E, et al.: Improved outcome in adult B-cell acute lymphoblastic leukemia. Blood 1996, 87:495–508.

    PubMed  CAS  Google Scholar 

  19. Patte C, Michon J, Frappaz D, et al.: Therapy of Burkitt and other B-cell acute lymphoblastic leukaemia and lymphoma: experience with the LMB protocols of the SFOP (French Paediatric Oncology Society) in children and adults. Baillieres Clin Haematol 1994, 7:339–348.

    Article  PubMed  CAS  Google Scholar 

  20. Atra A, Gerrard M, Hobson R, et al.: Improved cure rate in children with B-cell acute lymphoblastic leukaemia (B-ALL) and stage IV B-cell non-Hodgkin’s lymphoma (B-NHL): results of the UKCCSG 9003 protocol. Br J Cancer 1998, 77:2281–2285.

    PubMed  CAS  Google Scholar 

  21. McMaster ML, Greer JP, Wolff SN, et al.: Results of treatment with high intensity, brief duration chemotherapy in poor prognosis non-Hodgkin’s lymphoma. Cancer 1991, 68:233–241.

    Article  PubMed  CAS  Google Scholar 

  22. Pees HW, Radtke H, Schwamborn J, Graf N: The BFMprotocol for HIV-negative Burkitt’s lymphomas and L3 ALL in adult patients: a high chance for cure. Ann Hematol 1992, 65:201–205.

    Article  PubMed  CAS  Google Scholar 

  23. Straus DJ, Wong GY, Liu J, et al.: Small non-cleaved-cell lymphoma (undifferentiated lymphoma, Burkitt’s type) in American adults: results with treatment designed for acute lymphoblastic leukemia. Am J Med 1991, 90:328–337.

    PubMed  CAS  Google Scholar 

  24. Todeschini G, Tecchio C, Degani D, et al.: Eighty-one percent event-free survival in advanced Burkitt’s lymphoma/leukemia: no differences in outcome between pediatric and adult patients treated with the same intensive pediatric protocol. Ann Oncol 1997, 8:77–81.

    Article  PubMed  Google Scholar 

  25. Weintraub M, Adde MA, Venzon DJ, et al.: Severe atypical neuropathy associated with administration of hematopoietic colony-stimulating factors and vincristine. J Clin Oncol 1996, 14:935–940.

    PubMed  CAS  Google Scholar 

  26. Atra A, Gerrard M, Hobson R, et al.: Outcome of relapsed or refractory childhood B-cell acute lymphoblastic leukaemia and B-cell non-Hodgkin’s lymphoma treated with the UKCCSG 9003/9002 protocols. Br J Haematol 2001, 112:965–968.

    Article  PubMed  CAS  Google Scholar 

  27. Philip T, Hartmann O, Pinkerton R, et al.: Curability of relapsed childhood B-cell non-Hodgkin’s lymphoma after intensive first line therapy: a report from the Societe Francaise d’Oncologie Pediatrique. Blood 1993, 81:2003–2006.

    PubMed  CAS  Google Scholar 

  28. Soussain C, Patte C, Ostronoff M, et al.: Small noncleaved cell lymphoma and leukemia in adults: a retrospective study of 65 adults treated with the LMB pediatric protocols. Blood 1995, 85:664–674.

    PubMed  CAS  Google Scholar 

  29. Sweetenham JW, Pearce R, Taghipour G, et al.: Adult Burkitt’s and Burkitt-like non-Hodgkin’s lymphoma—outcome for patients treated with high-dose therapy and autologous stem-cell transplantation in first remission or at relapse: results from the European Group for Blood and Marrow Transplantation. J Clin Oncol 1996, 14:2465–2472.

    PubMed  CAS  Google Scholar 

  30. Nademanee A, Molina A, O’Donnell MR, et al.: Results of high-dose therapy and autologous bone marrow/ stem cell transplantation during remission in poor-risk intermediate- and high-grade lymphoma: international index high and high-intermediate risk group. Blood 1997, 90:3844–3852.

    PubMed  CAS  Google Scholar 

  31. Nademanee A, Molina A, Dagis A, et al.: Autologous stem-cell transplantation for poor-risk and relapsed intermediate- and high-grade non-Hodgkin’s lymphoma. Clin Lymphoma 2000, 1:46–54.

    Article  PubMed  CAS  Google Scholar 

  32. Slavin S, Naparstek E, Nagler A, et al.: Allogeneic cell therapy with donor peripheral blood cells and recombinant human interleukin-2 to treat leukemia relapse after allogeneic bone marrow transplantation. Blood 1996, 87:2195–2204.

    PubMed  CAS  Google Scholar 

  33. Troussard X, Leblond V, Kuentz M, et al.: Allogeneic bone marrow transplantation in adults with Burkitt’s lymphoma or acute lymphoblastic leukemia in first complete remission. J Clin Oncol 1990, 8:809–812.

    PubMed  CAS  Google Scholar 

  34. Ungkanont A, Mongkonsritrakoon W, Jootar S, Srichaikul T: Allogeneic stem cell transplantation in a patient with refractory Burkitt’s lymphoma using non-myeloablative conditioning regimen. Bone Marrow Transplant 2000, 26:1351–1354.

    Article  PubMed  CAS  Google Scholar 

  35. Bureo E, Ortega JJ, Munoz A, et al.: Bone marrow transplantation in 46 pediatric patients with non- Hodgkin’s lymphoma. Spanish Working Party for Bone Marrow Transplantation in Children. Bone Marrow Transplant 1995, 15:353–359.

    PubMed  CAS  Google Scholar 

  36. Spina M, Tirelli U, Zagonel V, et al.: Burkitt’s lymphoma in adults with and without human immunodeficiency virus infection: a single-institution clinicopathologic study of 75 patients. Cancer 1998, 82:766–774.

    Article  PubMed  CAS  Google Scholar 

  37. Kirk O, Pedersen C, Cozzi-Lepri A, et al.: Non-Hodgkin lymphoma in HIV-infected patients in the era of highly active antiretroviral therapy. Blood 2001, 98:3406–3412.

    Article  PubMed  CAS  Google Scholar 

  38. Ratner L, Lee J, Tang S, et al.: Chemotherapy for human immunodeficiency virus-associated non-Hodgkin’s lymphoma in combination with highly active antiretroviral therapy. J Clin Oncol 2001, 19:2171–2178.

    PubMed  CAS  Google Scholar 

  39. Straus DJ, Huang J, Testa MA, Levine AM, Kaplan LD: Prognostic factors in the treatment of human immunodeficiency virus-associated non-Hodgkin’s lymphoma: analysis of AIDS Clinical Trials Group protocol 142—low-dose versus standard-dose m-BACOD plus granulocyte-macrophage colonystimulating factor. National Institute of Allergy and Infectious Diseases. J Clin Oncol 1998, 16:3601–3606.

    PubMed  CAS  Google Scholar 

  40. Davi F, Delecluse HJ, Guiet P, et al.: Burkitt-like lymphomas in AIDS patients: characterization within a series of 103 human immunodeficiency virus-associated non- Hodgkin’s lymphomas. Burkitt’s Lymphoma Study Group. J Clin Oncol 1998, 16:3788–3795.

    PubMed  CAS  Google Scholar 

  41. Tirelli U, Spina M, Jaeger U, et al.: Infusional CDE with rituximab for the treatment of human immunodeficiency virus-associated non-Hodgkin’s lymphoma: preliminary results of a phase I/II study. Recent Results Cancer Res 2002, 159:149–153.

    PubMed  CAS  Google Scholar 

  42. Tirelli U, Bernardi D: Impact of HAART on the clinical management of AIDS-related cancers. Eur J Cancer 2001, 37:1320–1324.

    Article  PubMed  CAS  Google Scholar 

  43. Thiessard F, Morlat P, Marimoutou C, et al.: Prognostic factors after non-Hodgkin lymphoma in patients infected with the human immunodeficiency virus: Aquitaine Cohort, France, 1986-1997. Groupe d’Epidemiologie Clinique du SIDA en Aquitaine (GECSA). Cancer 2000, 88:1696–1702.

    Article  PubMed  CAS  Google Scholar 

  44. Matthews GV, Bower M, Mandalia S, et al.: Changes in acquired immunodeficiency syndrome-related lymphoma since the introduction of highly active antiretroviral therapy. Blood 2000, 96:2730–2734.

    PubMed  CAS  Google Scholar 

  45. Krishnan A, Molina A, Zaia J, et al.: Autologous stem cell transplantation for HIV-associated lymphoma. Blood 2001, 98:3857–3859.

    Article  PubMed  CAS  Google Scholar 

  46. Campbell P, Iland H, Gibson J, Joshua D: Syngeneic stem cell transplantation for HIV-related lymphoma. Br J Haematol 1999, 105:795–798.

    Article  PubMed  CAS  Google Scholar 

  47. Molina A, Krishnan AY, Nademanee A, et al.: High dose therapy and autologous stem cell transplantation for human immunodeficiency virus-associated non- Hodgkin lymphoma in the era of highly active antiretroviral therapy. Cancer 2000, 89:680–689.

    Article  PubMed  CAS  Google Scholar 

  48. Gabarre J, Azar N, Autran B, et al.: High-dose therapy and autologous haematopoietic stem-cell transplantation for HIV-1-associated lymphoma. Lancet 2000, 355:1071–1072.

    Article  PubMed  CAS  Google Scholar 

  49. Levine AM, Seneviratne L, Tulpule A: Incidence and management of AIDS-related lymphoma. Oncology (Huntingt) 2001, 15:629–639.

    CAS  Google Scholar 

  50. Vaccher E, Tirelli U, Spina M, et al.: Age and serum lactate dehydrogenase level are independent prognostic factors in human immunodeficiency virus-related non-Hodgkin’s lymphomas: a single-institute study of 96 patients. J Clin Oncol 1996, 14:2217–2223.

    PubMed  CAS  Google Scholar 

  51. Jones DP, Mahmoud H, Chesney RW: Tumor lysis syndrome: pathogenesis and management. Pediatr Nephrol 1995, 9:206–212.

    Article  PubMed  CAS  Google Scholar 

  52. Flombaum CD: Metabolic emergencies in the cancer patient. Semin Oncol 2000, 27:322–334.

    PubMed  CAS  Google Scholar 

  53. Holland P, Holland NH: Prevention and management of acute hyperuricemia in childhood leukemia. J Pediatr 1968, 72:358–366.

    Article  PubMed  CAS  Google Scholar 

  54. Hogan DK, Rosenthal LD: Oncologic emergencies in the patient with lymphoma. Semin Oncol Nurs 1998, 14:312–320.

    Article  PubMed  CAS  Google Scholar 

  55. Smalley RV, Guaspari A, Haase-Statz S, et al.: Allopurinol: intravenous use for prevention and treatment of hyperuricemia. J Clin Oncol 2000, 18:1758–1763.

    PubMed  CAS  Google Scholar 

  56. Pui CH: Urate oxidase in the prophylaxis or treatment of hyperuricemia: the United States experience. Semin Hematol 2001, 38:13–21.

    Article  PubMed  CAS  Google Scholar 

  57. Link MP, Donaldson SS, Berard CW, et al.: Results of treatment of childhood localized non-Hodgkin’s lymphoma with combination chemotherapy with or without radiotherapy. N Engl J Med 1990, 322:1169–1174.

    Article  PubMed  CAS  Google Scholar 

  58. Link MP, Shuster JJ, Donaldson SS, et al.: Treatment of children and young adults with early-stage non-Hodgkin’s lymphoma. N Engl J Med 1997, 337:1259–1266.

    Article  PubMed  CAS  Google Scholar 

  59. Miron I, Frappaz D, Brunat-Mentigny M, et al.: Initial management of advanced Burkitt lymphoma in children: is there still a place for surgery? Pediatr Hematol Oncol 1997, 14:555–561.

    Article  PubMed  CAS  Google Scholar 

  60. Shamberger RC, Weinstein HJ: The role of surgery in abdominal Burkitt’s lymphoma. J Pediatr Surg 1992, 27:236–240.

    Article  PubMed  CAS  Google Scholar 

  61. Thieblemont C, Mayer A, Dumontet C, et al.: Primary thyroid lymphoma is a heterogeneous disease. J Clin Endocrinol Metab 2002, 87:105–111.

    Article  PubMed  CAS  Google Scholar 

  62. Kemeny MM, Magrath IT, Brennan MF: The role of surgery in the management of American Burkitt’s lymphoma and its treatment. Ann Surg 1982, 196:82–86.

    Article  PubMed  CAS  Google Scholar 

  63. Dechambenoit G, Piquemal M, Giordano C, et al.: Spinal cord compression resulting from Burkitt’s lymphoma in children. Childs Nerv Syst 1996, 12:210–214.

    Article  PubMed  CAS  Google Scholar 

  64. Witzig TE: Radioimmunotherapy for patients with relapsed B-cell non-Hodgkin lymphoma. Cancer Chemother Pharmacol 2001, 48:S91-S95.

    Article  PubMed  Google Scholar 

  65. Thomas DA: Rituximab and hyper-CVAD for adult Burkitt’s (BL) or Burkitt-like (BLL) leukemia or lymphoma. Blood 2001:a3342.

  66. Macpherson N, Lesack D, Klasa R, et al.: Small noncleaved, non-Burkitt’s (Burkit-like) lymphoma: cytogenetics predict outcome and reflect clinical presentation. J Clin Oncol 1999, 17:1558–1567.

    PubMed  CAS  Google Scholar 

  67. Bemark M, Neuberger MS: The c-MYC allele that is translocated into the IgH locus undergoes constitutive hypermutation in a Burkitt’s lymphoma line. Oncogene 2000, 19:3404–3410.

    Article  PubMed  CAS  Google Scholar 

  68. Hu HM, Arcinas M, Boxer LM: A Myc-associated zinc finger protein-related factor binding site is required for the deregulation of c-myc expression by the immunoglobulin heavy chain gene enhancers in Burkitt’s lymphoma. J Biol Chem 2002, 277:9819–9824.

    Article  PubMed  CAS  Google Scholar 

  69. Madisen L, Krumm A, Hebbes TR, Groudine M: The immunoglobulin heavy chain locus control region increases histone acetylation along linked c-myc genes. Mol Cell Biol 1998, 18:6281–6292.

    PubMed  CAS  Google Scholar 

  70. Sommer A, Hilfenhaus S, Menkel A, et al.: Cell growth inhibition by the Mad/Max complex through recruitment of histone deacetylase activity. Curr Biol 1997, 7:357–365.

    Article  PubMed  CAS  Google Scholar 

  71. Luscher B: Function and regulation of the transcription factors of the Myc/Max/Mad network. Gene 2001, 277:1–14.

    Article  PubMed  CAS  Google Scholar 

  72. Yin X, Landay MF, Han W, et al.: Dynamic in vivo interactions among Myc network members. Oncogene 2001, 20:4650–4664.

    Article  PubMed  CAS  Google Scholar 

  73. Alizadeh AA, Eisen MB, Davis RE, et al.: Distinct types of diffuse large B-cell lymphoma identified by gene expression profiling. Nature 2000, 403:503–511.

    Article  PubMed  CAS  Google Scholar 

  74. Chan WC, Huang JZ: Gene expression analysis in aggressive NHL. Ann Hematol 2001, 80:B38-B41.

    Article  PubMed  CAS  Google Scholar 

  75. Shipp MA, Ross KN, Tamayo P, et al.: Diffuse large B-cell lymphoma outcome prediction by geneexpression profiling and supervised machine learning. Nat Med 2002, 8:68–74.

    Article  PubMed  CAS  Google Scholar 

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Evens, A.M., Gordon, L.I. Burkitt’s and Burkitt-like Lymphoma. Curr. Treat. Options in Oncol. 3, 291–305 (2002). https://doi.org/10.1007/s11864-002-0029-9

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