Treating Burkitt Lymphoma in Adults
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Burkitt lymphoma is an uncommon form of aggressive lymphoma affecting approximately 1200 patients per year in the USA. It is characterized by a translocation involving the MYC oncogene. Three subtypes of Burkitt lymphoma are recognized: the endemic form, occurring primarily in Africa and associated with the Epstein-Barr virus (EBV); the sporadic form, representing less than 3 % of all non-Hodgkin lymphomas (NHL); and the immunodeficiency-associated form, occurring primarily in HIV-infected patients. Burkitt lymphoma appears histologically with a diffuse pattern of intermediate-sized monomorphic B cells, multiple nucleoli, a very high proliferative rate, and frequent mitotic figures. Recent advances in transcriptional profiling have improved the current molecular understanding of Burkitt lymphoma and have better characterized its mutational landscape. Most Burkitt lymphoma patients are cured with intensive treatment; however, prognosis is poor in elderly patients and those with relapsed disease.
KeywordsBurkitt lymphoma Non-Hodgkin lymphomas MYC oncogene Hodgkin lymphoma
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- 5.de-The G, Geser A, Day NE, et al. Epidemiological evidence for causal relationship between Epstein-Barr virus and Burkitt’s lymphoma from Ugandan prospective study. Nature. 1978;274:756–61.Google Scholar
- 7.Torgbor C, Awuah P, Deitsch K, Kalantari P, Duca KA, Thorley-Lawson DA. A multifactorial role for P. falciparum malaria in endemic Burkitt’s lymphoma pathogenesis. PLoS Path. 2014;10:e1004170.Google Scholar
- 10.Mbulaiteye SM, Anderson WF, Bhatia K, Rosenberg PS, Linet MS, Devesa SS. Trimodal age-specific incidence patterns for Burkitt lymphoma in the United States, 1973–2005. Int J Canc J Int Canc. 2010;126:1732–9.Google Scholar
- 15.•Schmitz R, Young RM, Ceribelli M, et al. Burkitt lymphoma pathogenesis and therapeutic targets from structural and functional genomics. Nature. 2012;490:116–20. This paper highlights novel methods of high throughput sequencing to reveal novel mutations contributing to BL pathogenesis” suggesting opportunities to improve therapy for patients with BL. PubMedCentralCrossRefPubMedGoogle Scholar
- 18.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 Offic J Am Soc Clin Oncol. 1996;14:925–34.Google Scholar
- 26.••Dunleavy K, Pittaluga S, Shovlin M, et al. Low-intensity therapy in adults with Burkitt’s lymphoma. N Engl J Med. 2013;369:1915–25. This very important paper demonstrates that with lower intensity infusional chemotherapy, patients with BL have excellent outcomes with manageable toxicity. This paper also deals with CNS prophylaxis as well as addressing CNS involvement of BL patients. PubMedCentralCrossRefPubMedGoogle Scholar
- 27.Thomas DA, Cortes J, O’Brien S, et al. Hyper-CVAD program in Burkitt’s-type adult acute lymphoblastic leukemia. J Clin Oncol Offic J Am Soc Clin Oncol. 1999;17:2461–70.Google Scholar
- 29.•Rizzieri DA, Johnson JL, Byrd JC, et al. Improved efficacy using rituximab and brief duration, high intensity chemotherapy with filgrastim support for Burkitt or aggressive lymphomas: Cancer and Leukemia Group B Study 10 002. Br J Haematol. 2014;165:102–11. This large study demonstrated that a brief but highly intense chemotherapy program is feasible and effective in a multicenter setting. PubMedCentralCrossRefPubMedGoogle Scholar
- 30.Sweetenham JW, Pearce R, Taghipour G, Blaise D, Gisselbrecht C, Goldstone AH. 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 Offic J Am Soc Clin Oncol. 1996;14:2465–72.Google Scholar
- 37.Tan Y, Sementino E, Pei J, Kadariya Y, Ito TK, Testa JR. Co-targeting of Akt and Myc inhibits viability of lymphoma cells from Lck-Dlx5 mice. Cancer Biol Ther. 2015;16(4):580-8. doi: 10.1080/15384047.2015.1018495.