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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
Find out how we produce our information|
This information is about a type of non-Hodgkin lymphoma| called Burkitt lymphoma.
Non-Hodgkin lymphoma is a cancer of the lymphatic system|. This is part of the body’s immune system and helps us fight infection. It's made up of organs such as the bone marrow, thymus, spleen, and the lymph nodes (or lymph glands). Lymph nodes are connected by a network of tiny lymphatic vessels that contain lymph fluid.
There is also lymphatic tissue in other organs, such as the skin, lungs and stomach.
There are lymph nodes all over the body. As lymph fluid flows through the lymph nodes, the nodes collect and filter out anything that is harmful or that the body doesn't need. This includes bacteria, viruses, damaged cells and cancer cells.
The lymphatic system View a large copy of the diagram of the lymphatic system|
Lymph fluid contains cells called lymphocytes. These are a type of white blood cell that help the body fight infection and disease.
Lymphocytes start to grow in the bone marrow, which is where blood cells are made. The two main types of lymphocytes are B-cells and T-cells.
B-cells mature in the bone marrow, while T-cells mature in the thymus gland behind the breast bone. When they're mature, both B-cells and T-cells help fight infections.
Lymphoma is a disease in which either T-cells or B-cells grow in an uncontrolled way.
There are many different types of non-Hodgkin lymphomas. They're grouped (or classified) according to certain characteristics. The most widely used classification system is produced by the World Health Organisation|.
Burkitt lymphoma (BL) is a rare type of B-cell lymphoma. It affects both children and young adults. It's more common in men than in women.You might find it useful to read our section on children's cancers|.
BL is named after the doctor who first described this kind of tumour in children in Africa. This type of BL is known as endemic or African-type BL. It also occurs in people in other countries and this is usually called sporadic BL.
BL can also affect people who have poor immunity.
The different types are:
This is found in central Africa, usually in children, and is strongly linked to reduced resistance to a common virus called the Epstein-Barr virus (EBV). The jaw bone is often affected, which is rare in other types of BL.
This is also linked with the Epstein-Barr virus, which causes glandular fever, but less clearly than with endemic BL. Epstein-Barr is a common virus and it is not known why it may increase the risk of lymphoma in some people but not others.
This usually occurs in people with HIV or AIDS, who have poor immunity, or in people who are taking medicines (immunosuppressive drugs) after an organ transplant.
We have separate information about HIV-related lymphomas|, as they may be treated differently.
BL often affects the bowel and the lymph nodes in the tummy (abdomen), causing symptoms such as pain|, feeling sick (nausea|) and diarrhoea|. It can sometimes cause a blockage in the bowel. Lymph nodes in the chest or throat can also become enlarged.
BL can cause different symptoms depending on where else in the body it has spread. It may involve the bone marrow, spleen and liver, and sometimes may spread to the brain and spinal cord.
Other symptoms, known as B symptoms, include night sweats, unexplained high temperatures and weight loss.
A diagnosis is made by removing an enlarged lymph node (a biopsy) and examining the cells under a microscope. It is a very small operation and may be done under local or general anaesthetic. Biopsies may also be taken from other areas of the body.
Additional tests – including blood tests, x-rays, scans, lumbar punctures and bone marrow samples – are then used to find out more about the type of lymphoma and how far it has spread in the body. This information is used to help decide which treatment is most appropriate. We have more information about tests for non-Hodgkin lymphoma|.
The stage of non-Hodgkin lymphoma describes how many groups of lymph nodes are affected, where they are in the body and whether other organs such as the bone marrow or liver are involved. The system that's usually used for BL is the St Jude/Arbor staging system.
Nodal means that the lymphoma is in the the lymph nodes. Sometimes the lymphoma can start in areas outside the lymph nodes. This is called extranodal lymphoma.
There is one extranodal tumour or a single group of lymph nodes affected, but not in the chest or abdomen. A group of lymph nodes refers to lymph nodes in one area of the body, such as in the armpit, on one side of the neck or in the groin.
Can be any of the following:
The lymphoma was in the abdominal area but has been completely removed by surgery.
The lymphoma is in the abdominal area only and cannot be removed by surgery.
The lymphoma is affecting several organs within the abdomen.
Any of the above and at diagnosis, the brain and spinal cord (central nervous system) and/or the bone marrow are also affected.
For practical purposes, non-Hodgkin lymphomas are divided into two groups: low-grade and high-grade. Low-grade lymphomas are usually slow-growing and high-grade lymphomas grow more quickly.
BL is a high-grade lymphoma. This means that it grows quickly and needs to be treated immediately with chemotherapy.
Chemotherapy is the main treatment for BL. It is usually an intensive treatment and involves staying in hospital for weeks at a time. A monoclonal antibody drug called rituximab (Mabthera®) can be given in addition to chemotherapy. Some people may have stem cell treatment.
Chemotherapy| is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. The combination of drugs you have will depend on the stage of the lymphoma and how fit you are to cope with the side effects.
The chemotherapy drugs are given into a vein (intravenously). The following drugs may be used in different combinations to treat BL: cyclophosphamide, vincristine, doxorubicin, methotrexate, ifosfamide, cytarabine and etoposide. Your specialist will explain which combination of the drugs is the most appropriate for you.
This is chemotherapy given directly into the fluid that surrounds the brain and spinal cord (cerebrospinal fluid). It is done either to prevent lymphoma cells from spreading into the cerebrospinal fluid or to treat it if it already has.
A monoclonal antibody| drug called rituximab (Mabthera®)| may also be given, usually with chemotherapy. Monoclonal antibodies are drugs that recognise, target and stick to specific proteins on the surface of cancer cells. They can stimulate the body’s immune system to destroy the cell.
Some people with lymphoma may have treatments using their own stem cells| or stem cells from a donor|. Stem cells are a special type of blood cell that can make all other types of blood cells.
This treatment is not suitable for everyone and is not done routinely. Doctors take into account a person's general health and age before recommending them.
Some people have some of their own stem cells collected and stored. This allows them to have higher doses of chemotherapy to destroy the lymphoma cells. After the chemotherapy, their stem cells are returned by a drip (like a blood transfusion) to help their blood cells recover from the effects of chemotherapy. This is called an autologous transplant.
Some people may have treatment using stem cells from another person (a donor). This is called an allogeneic transplant.
Steroids| are drugs that are often given with chemotherapy to help treat lymphomas. They also help you feel better and can reduce feelings of sickness|.
New treatments for Burkitt lymphoma are being researched all the time. Your doctor may invite you to take part in a clinical trial| to compare a new treatment against the best available standard treatment.
Your doctor must discuss the treatment with you, and have your informed consent before entering you into a trial.
Before any trial is allowed to take place, it must be approved by a research ethics committee, which protects the interests of those taking part.
You may decide not to take part or to withdraw from the trial at any stage. You will then receive the best standard treatment available.
Everyone has their own way of dealing with their illness and the different emotions| they experience. You may find it helpful to talk things over with family and friends or your doctor or nurse. You can also contact our cancer support specialists| or the organisations listed below for more information and support.
This section has been compiled using information from a number of reliable sources, including:
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.