A type of B-cell non-Hodgkin lymphoma, Burkitt lymphoma is an aggressive lymphatic cancer that mainly affects children and, less frequently, young adults. It is most common in boys between ages five and 10. The initial tumor may develop in the jaw, bowel or urinary tract and can potentially spread to the bone marrow or spinal fluid.
Named for Dr. Dennis Burkitt, the surgeon who first identified this specific malignancy, Burkitt lymphoma is common in Central Africa but relatively rare in the United States and other Western countries.
Types of Burkitt lymphoma
Burkitt lymphoma may be categorized as:
- Endemic Burkitt lymphoma. The most common type of Burkitt lymphoma and the most common childhood cancer overall, endemic Burkitt lymphoma usually develops in the jaw and mostly affects children in Africa.
- Sporadic Burkitt lymphoma. Accounting for less than 1% of all B-cell non-Hodgkin adult lymphomas and 30% of all childhood lymphomas in the United States and Western Europe, sporadic Burkitt lymphoma usually starts in the stomach cavity.
- Immunodeficiency-related Burkitt lymphoma. Most common in people who have human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS), immunodeficiency-related Burkitt lymphoma can also occur in people who have inherited immune deficiencies or have taken immunosuppressive medications to help prevent organ rejection after a transplant.
Causes of and risk factors for Burkitt lymphoma
Scientists continue to investigate the possible causes of Burkitt lymphoma, which are not yet well understood. Researchers have linked the condition to acquired (uninherited) changes in chromosome 8 of the MYC gene, which controls certain aspects of cellular growth. More specifically, genes are swapped between a part of chromosome 8 and a part of chromosome 14, 2 or 22. The drivers of this genetic mutation are unknown.
Some people who are diagnosed with Burkitt lymphoma also have Epstein-Barr virus (EBV). However, the latter condition is quite common, and scientists have not conclusively established a link between the two.
Signs and symptoms of Burkitt lymphoma
Usually, the first indication of Burkitt lymphoma is painless lymph node swelling.
Other signs of Burkitt lymphoma in children can include:
- Pain and swelling in the midsection
- Nausea and vomiting
- Loss of appetite
- Early satiety (a feeling of fullness after eating only a small amount of food)
- Weakness and fatigue
- Itchy skin
- Coughing and difficulty breathing
Other signs of Burkitt lymphoma in adults can include:
- Fever and chills
- Drenching night sweats
- Unintended weight loss
Usually, Burkitt lymphoma symptoms appear suddenly and worsen rapidly as the cancer progresses.
Diagnosing Burkitt lymphoma
A hallmark sign of Burkitt lymphoma—and therefore a key finding in the diagnostic process—is the rearrangement (translocation) of the MYC gene, which can be identified in a tissue biopsy. When viewed under a microscope, Burkitt lymphoma cells often exhibit the pattern of a “starry sky,” with many small round blue cells interspersed with star-like macrophage cells. Special stains that are used to evaluate the cellular proteins may reveal a cancer marker known as CD20.
In addition to a tissue biopsy, other tests that may be used during the diagnostic process include:
- Blood work
- Chest X-ray
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI) scan
- Bone marrow aspiration
- Lumbar puncture
In adults, Burkitt lymphoma is often indistinguishable from diffuse large B-cell lymphoma (DLBCL), another aggressive type of B-cell lymphoma. Because Burkitt lymphoma and DLBCL are treated differently, an accurate diagnosis is essential.
Burkitt lymphoma treatment
Burkitt lymphoma is a fast-growing cancer, and a diagnosis usually signals a medical emergency that requires immediate hospitalization and treatment. With that said, Burkitt lymphoma is often very responsive to treatment, which typically involves short courses of intensive chemotherapy. If a single large tumor is detected, it may be surgically removed before chemotherapy begins.
The choice of initial chemo medications can vary depending on several factors, including the patient’s age, overall health and cancer stage. Promising new chemotherapy drugs and drug combinations are currently under investigation in clinical trials. These important studies play a crucial role in identifying effective medications as well as the optimal doses for patients with Burkitt lymphoma.
Burkitt lymphoma can also be treated with targeted therapy, which involves the use of drugs that target specific molecules (such as proteins) that control cellular growth and are found on the surface of the cancer cells. By damaging these molecules, the drugs can inhibit the spread of the cancer cells while minimizing the effect on healthy cells.
How Moffitt Cancer Center approaches Burkitt lymphoma
The renowned researchers and clinicians at Moffitt Cancer Center are dedicated to a singular lifesaving mission: to contribute to the prevention and cure of all types of cancer, including Burkitt lymphoma. The multispecialty team in our Malignant Hematology Program includes experts in many disciplines who collaborate to provide comprehensive patient care. In addition to the latest screening, diagnostic and treatment services, we have a robust clinical trials program through which our patients can benefit from innovative treatment options that are not yet available in other settings.
If you would like to learn more about Burkitt lymphoma, you are encouraged to talk with an oncologist at Moffitt. You can request an appointment by calling 1-888-663-3488 or submitting a new patient registration form online. A referral is not required.
As Florida’s top cancer hospital, Moffitt has expanded the traditional patient care model to help each patient get started on an individualized treatment plan as soon as possible. We know that every day counts after a cancer diagnosis, and we do everything we can to help our patients achieve the best possible outcome and quality of life.