Skip to main content
SpringerLink
Log in

Gastric Burkitt lymphoma is a distinct subtype that has superior outcomes to other types of Burkitt lymphoma/leukemia

  • Original Article
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Abstract

Burkitt lymphoma/leukemia (BL) is a highly aggressive non-Hodgkin's lymphoma (NHL) often presenting in extranodal sites or as an acute leukemia. Because of the shared molecular and genetic features, the World Health Organization classification of lymphoid diseases recognizes the lymphomatous and leukemic phases of BL as a single entity: a mature B cell neoplasm, subtype Burkitt lymphoma/Burkitt cell leukemia. Because BL frequently appears in the stomach, we investigated the clinical presentation and outcome of gastric BL. We discovered 21 patients with gastric BL through a survey of our NHL registry, and retrospectively analyzed the distinct features of BL, including the St Jude/Murphy staging, other extranodal involvement, morphology and immunophenotype, response to treatment, and clinical outcome. The patients' median age was 48 years (range, 7–75), and the male-to-female ratio was 2.5. Stage 1 was found in five patients, stage 2 in five patients, and stage 4 in 11 patients. The stomach body and antrum were most frequently involved. All 21 patients were treated with systemic intensive chemotherapy, producing a 71% (15/21) rate of complete response (CR) to chemotherapy. Both the 2-year disease-free and overall survival rates were 55%. All ten patients in BL stages 1 and 2 showed outstanding outcomes, and nine of the ten patients exhibited CR and long-term survival. These data show that a high proportion of patients with gastric BL have a localized disease that is limited to stage 1 and 2, and that these localized BLs have outstanding outcomes. These findings suggest that these BLs could represent a distinct subtype that might have a different biology, which needs to be defined.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

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

    CAS  PubMed  Google Scholar 

  2. Amer MH, El-Akkad S (1994) Gastrointestinal lymphoma in adults: clinical features and management of 300 cases. Gastroenterology 106:846–858

    CAS  PubMed  Google Scholar 

  3. Bennett J, Catovsky D, Daniel M et al (1985) Proposed revised criteria for the classification of acute myeloid leukemia: a report of the French-American-British Cooperative Group. Ann Intern Med 103:620–625

    CAS  PubMed  Google Scholar 

  4. Bernstein J, Coleman C, Strickler J et al (1986) Combined modality therapy for adults with small noncleaved cell lymphoma (Burkitt's and non-Burkitt's types). J Clin Oncol 4:847–858

    CAS  PubMed  Google Scholar 

  5. Binn M, Ruskone-Fourmestraux A, Lepage E, Haioun C, Delmer A, Aegerter P et al (2003) Surgical resection plus chemotherapy versus chemotherapy alone: comparison of two strategies to treat diffuse large B-cell gastric lymphoma. Ann Oncol 14:1751–1757

    Article  CAS  PubMed  Google Scholar 

  6. Blum KA, Lozanski G, Byrd JC (2004) Adult Burkitt leukemia and lymphoma. Blood 104:3009–3020

    Article  CAS  PubMed  Google Scholar 

  7. Cabanillas M, Thomas D, Cortes J et al (2003) Outcome with hyper-CVAD and rituximab in Burkitt (BL) and Burkitt-like (BLL) leukemia/lymphoma. Proc Am Soc Clin Oncol 22:2309 (abstract)

    Google Scholar 

  8. Crump M, Gospodarowicz M, Shepherd FA (1999) Lymphoma of the gastrointestinal tract. Semin Oncol 26:324–337

    CAS  PubMed  Google Scholar 

  9. d'Amore F, Christensen BE, Brincker H et al (1991) Clinicopathological features and prognostic factors in extranodal non-Hodgkin lymphomas. Eur J Cancer 27:1201–1208

    Article  PubMed  Google Scholar 

  10. Divine M, Lepage E, Briere J et al (1996) Is the small non-cleaved cell lymphoma histologic subtype a poor prognostic factor in adult patients? A case controlled analysis. J Clin Oncol 24:240–248

    Google Scholar 

  11. Divine M, Cassasus P, Koscielny S et al (2000) Adult Burkitt lymphoma. A prospective multicenter trial with the LMB protocol. Proc Am Soc Clin Oncol 19:80 (abstract)

    Google Scholar 

  12. Dragosics B, Baur P, Radaszkiewicz T (1985) Primary gastrointestinal non-Hodgkin's lymphomas. A retrospective clinicopathological study of 150 cases. Cancer 55:1060–1073

    Article  CAS  PubMed  Google Scholar 

  13. Gurney KA, Cartwright RA, Gilman EA (1999) Descriptive epidemiology of gastrointestinal non-Hodgkin's lymphoma in a population-based registry. Br J Cancer 79:1929–1934

    Article  CAS  PubMed  Google Scholar 

  14. Jaffe ES, Harris NL, Stein H, Vardiman JW (2001) World Health Organization classification of tumours; tumours of haematopoietic and lymphoid tissues. IARC Press, Lyon

    Google Scholar 

  15. Ko YH, Kim CW, Park CS, Jang HK, Lee SS, Kim SH et al (1998) REAL classification of malignant lymphomas in the Republic of Korea: incidence of recently recognized entities and changes in clinicopathologic features. Hematolymphoreticular Study Group of the Korean Society of Pathologists. Revised European-American lymphoma. Cancer 83:806–812

    Article  CAS  PubMed  Google Scholar 

  16. Koch P, del Valle F, Berdel WE, Willich NA, Reers B, Hiddemann W et al (2001) German Multicenter Study Group. Primary gastrointestinal non-Hodgkin's lymphoma: I. anatomic and histologic distribution, clinical features, and survival data of 371 patients registered in the German Multicenter Study GIT NHL 01/92. J Clin Oncol 19:3861–3873

    CAS  PubMed  Google Scholar 

  17. Krugmann J, Tzankov A, Fiegl M et al (2004) Burkitt's lymphoma of the stomach: a case report with molecular cytogenetic analysis. Leuk Lymphoma 45:1055–1059

    Article  PubMed  Google Scholar 

  18. LaCasce A, Howard O, Li S et al (2003) The Magrath regimen is effective in older adults with Burkitt's and Burkitt-like lymphomas. Proc Am Soc Clin Oncol 21:1150 (abstract)

    Google Scholar 

  19. Lee E, Pertroni G, Schiffer C et al (2001) Brief-duration high-intensity chemotherapy for patients with small noncleaved-cell lymphoma: results of cancer and leukemia group B study 9251. J Clin Oncol 19:4014–4022

    CAS  PubMed  Google Scholar 

  20. Liu HT, Hsu C, Chen CL, Choang IP, Chen LT, Chen YC et al (2000) Chemotherapy alone versus surgery followed by chemotherapy for stage I/IIE large-cell lymphoma of the stomach. Am J Hematol 64:175–179

    Article  CAS  PubMed  Google Scholar 

  21. Longo D, Duffey P, Jaffe E et al (1994) Diffuse small noncleaved-cell, non-Burkitt's lymphoma in adults: a high-grade lymphoma responsive to ProMACE-based combination therapy. J Clin Oncol 12:2153–2159

    CAS  PubMed  Google Scholar 

  22. Lopez T, Hagemeister F, McLaughlin P et al (1990) Small noncleaved cell lymphoma in adults: superior results for stages I–III disease. J Clin Oncol 8:615–622

    CAS  PubMed  Google Scholar 

  23. Magrath I, Adde M, Shad A, Venzon D, Seibel N, Gootenberg J, Neely J, Arndt C, Nieder M, Jaffe E, Wittes RA, Horak ID (1996) Adults and children with small non-cleaved-cell lymphoma have a similar excellent outcome when treated with the same chemotherapy regimen. J Clin Oncol 14:925–934

    CAS  PubMed  Google Scholar 

  24. MØller MB, Pedersen NT, Christensen BE (2004) Diffuse large B-cell lymphoma: clinical implications of extranodal versus nodal presentation—a population-based study of 1575 cases. Br J Haematol 124:151–159

    Article  PubMed  Google Scholar 

  25. Nakamura S, Akazawa K, Yao K et al (1995) Primary gastric lymphoma—a clinicopathologic study of 233 cases with special reference to evaluation with the MIB-1 index. Cancer 76:1313–1325

    Article  CAS  PubMed  Google Scholar 

  26. Philip T, Meckenstock R, Deconnick E et al (1992) Treatment of poor prognosis Burkitt's lymphoma in adults with the Societe Francaise d'Oncologie Pediatrique LMB protocol—a study of the Federation Nationale des Centres de Lutte Contre le Cancer (FNLCC). Eur J Cancer 28A:1954–1959

    Article  CAS  PubMed  Google Scholar 

  27. Raderer M, Valencak J, Osterreicher C, Drach J, Hejna M, Kornek G et al (2000) Chemotherapy for the treatment of patients with primary high grade gastric B-cell lymphoma of modified Ann Arbor stages IE and IIE. Cancer 88: 1979–1985

    Article  CAS  PubMed  Google Scholar 

  28. Todeschini G, Tecchio C, Dagani D et al (1997) 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 8:S77–S81

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Hematology-Oncology, Department of Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, 215-4, Gongneung-dong, Nowon-ku, 139-706, Seoul, South Korea

    Yeon Hee Park, Hye Jin Kang, Im Il Na, Baek-Yeol Ryoo & Sung Hyun Yang

  2. Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Won Seog Kim, Ji Eun Uhm, Kihyun Kim, Chul Won Jung & Keunchil Park

  3. Department of Pathology, Korea Institute of Radiological & Medical Sciences, Seoul, South Korea

    Seung-Sook Lee

  4. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Young H. Ko

Authors
  1. Yeon Hee Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Won Seog Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hye Jin Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Im Il Na
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Baek-Yeol Ryoo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sung Hyun Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Seung-Sook Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ji Eun Uhm
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kihyun Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Chul Won Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Keunchil Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Young H. Ko
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Baek-Yeol Ryoo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Park, Y.H., Kim, W.S., Kang, H.J. et al. Gastric Burkitt lymphoma is a distinct subtype that has superior outcomes to other types of Burkitt lymphoma/leukemia. Ann Hematol 85, 285–290 (2006). https://doi.org/10.1007/s00277-005-0050-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00277-005-0050-8

Keywords

Search

Navigation