Burkitt’s lymphoma is a type of blood cancer, considered rare and particularly aggressive. Lymphomas are developed due to an abnormal reproduction and enlargement of the white blood cells called lymphocytes and they can be classified as Hodgkin’s or non-Hodgkin’s lymphoma. Burkitt’s lymphoma is a non-Hodgkin’s lymphoma originated in the B-cells. It can turn rapidly fatal if untreated in a timely manner.
The disease is named after Denis Burkitt, a British surgeon who was the first to identify the disease in African children.
It was 1956 when the surgeon demonstrated the existence of the fastest growing tumor related to impaired immunity. This type of lymphoma continues to be a great problem among children and adults in Africa, because of the prevalence of diseases that weaken the immune system. Outside the continent, the disease is rare. In the United States, only about 1,200 cases are diagnosed annually.
Burkitt’s Lymphoma Development and Risk Factors
There are three sub-types of Burkitt’s lymphoma, the sporadic, the endemic and the immunodeficiency-related Burkitt’s lymphoma, which are different according to the body parts involved and the geographic location. While the causes for the development of the disease are not fully known, the risk factors involved also differ depending on the geographic location of the patient. In Africa and other places with high incidence of malaria, the disease is most common among children. Everywhere else, the major risk factor is HIV/AIDS.
Patients with weakened immune systems are more apt to develop Burkitt’s lymphoma, with higher incidence among children and patients older than age 59. Scientists believe that the strong correlation between Burkitt’s lymphoma and both malaria and the virus responsible for infectious mononucleosis, Epstein-Barr, is related to the fact that these conditions cause impairments in the body’s immune response, which enables B-cells to change into cancerous cells.
Burkitt’s Lymphoma Symptoms and Diagnosis
The first symptoms experienced by patients suffering from Burkitt’s lymphoma include fever, night sweats and unexplained weight loss.
Both sporadic and immunodeficiency-related Burkitt’s lymphoma can also cause pain and swelling in the abdomen, distortion of the facial bones, intestinal obstruction, and enlarged thyroid or tonsils. Endemic Burkitt’s lymphoma may cause swelling and distortion of the facial bones, swollen lymph nodes, and the development of fast-growing tumors.
Because the disease spreads rapidly and can turn quickly fatal, an early diagnosis is vital to assuring the success of treatment. When a physician suspects Burkitt’s lymphoma, a biopsy is usually the first step to confirm or exclude the diagnosis. The physician may also order chest, abdomen and pelvis computed tomographic (CT) imaging, a chest x-ray, a positron emission tomography (PET) scan, spinal fluid exam. Blood test will also be ordered to evaluate kidney and liver funtions, and to test for the presence of HIV.
Treatment and Prognosis of Burkitt’s Lymphoma
The severity and rapid expansion of Burkitt’s lymphoma requires an aggressive response.
The disease is most commonly treated with a combination of chemotherapy, involving cytarabine, cyclophosphamide, doxorubicin, vincristine, methotrexate, and etoposide. The physician may also recommend a treatment with the monoclonal antibody rituximab, in addition to chemotherapy. The therapy is usually injected straight to the spine to decrease the possibility of it spreading to the central nervous system.
In the case of intestinal obstruction, surgery may be needed. Intensive chemotherapy usually results in better treatment outcomes, but in developing countries the treatment trends are less aggressive.
The prognosis for patients with Burkitt’s lymphoma is better for children, with long-term survival rates between 60 and 90%, when treated with intensive chemotherapy. The same treatment in adults result in 70 to 80% long-term survival.
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