Burkitt lymphoma is a form of non-Hodgkin's lymphoma in which cancer starts in immune cells called B-cells. Recognized as a fast growing human tumor, Burkitt lymphoma is associated with impaired immunity and is rapidly fatal if left untreated. However, intensive chemotherapy can achieve long-term survival in more than half the people with Burkitt lymphoma.

Types of Burkitt Lymphoma

In the World Health Organization classification, there are three types of Burkitt lymphoma:

• Endemic (African)
• Sporadic (non-African)
• Immunodeficiency-associated

Symptoms of Burkitt Lymphoma

The symptoms of Burkitt lymphoma depend on the type. The endemic (African) variant usually starts as tumors of the jaw or other facial bones. It also can affect the gastrointestinal tract, ovaries, and breasts and can spread to the central nervous system, causing nerve damage, weakness, and paralysis.

Other symptoms associated with Burkitt lymphoma include:

• Loss of appetite
• Weight loss
• Fatigue
• Night sweats
• Unexplained fever

Diagnosis of Burkitt Lymphoma

Because Burkitt lymphoma spreads so quickly, prompt diagnosis is essential.

If Burkitt lymphoma is suspected, all or part of an enlarged lymph node or other suspicious disease site will be biopsied. In a biopsy, a sample of tissue is examined under a microscope. This will confirm or rule out Burkitt lymphoma.

Additional tests may include:

• Computed tomographic (CT) imaging of the chest, abdomen, and pelvis
• Chest X-ray
• PET or gallium scan
• Bone marrow biopsy
• Exam of spinal fluid
• Blood tests to measure kidney and liver function
• Testing for HIV disease

Treatments for Burkitt Lymphoma

Intensive intravenous chemotherapy -- which usually involves a hospital stay -- is the preferred treatment for Burkitt lymphoma. Because Burkitt lymphoma can spread to the fluid surrounding the brain and spinal cord, chemotherapy drugs also may be injected directly into the cerebrospinal fluid, a treatment known as intrathecal chemotherapy.

Examples of drugs that may be used in various combinations for Burkitt lymphoma include:

• cyclophosphamide
• cytarabine
• doxorubicin (Adriamycin)
• etoposide (Etopophos, Toposar, VePesid)
• methotrexate (Ortrexup, Rasuvo, Rheumatrex, Trexall, Xatmep)
• vincristine

Other treatments for Burkitt lymphoma may include intensive chemotherapy in combination with:

Rituximab (Rituxan), a monoclonal antibody that sticks to proteins on cancer cells and stimulates the immune system to attack cancer cells

Autologous stem cell transplantation, in which the patient's stem cells are removed, stored, and returned to the body

• Radiation therapy
• Steroid therapy

In some cases, surgery may be needed to remove parts of the intestine that are blocked, bleeding, or have ruptured.

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