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This information is about a type of non-Hodgkin lymphoma called Burkitt lymphoma. It should ideally be read with our general information about non-Hodgkin lymphoma.
We hope this information answers your questions. If you have any further questions, you can ask your doctor or nurse at the hospital where you are having treatment.
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.
The lymphatic system
View a large copy of the diagram of the lymphatic system|
Lymph fluid contains 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, 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, such as the type of cell involved (B-cells or T-cells). 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.
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 of Burkitt lymphoma 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 may occur in people with HIV or AIDS, who have reduced immunity. We have separate information about HIV-related lymphomas as they may be treated differently. Immunodeficiency-associated BL may also occur in people who have had an organ transplant and are taking medicines to suppress their immune system so it doesn’t reject the donor organ.
It often appears as a lump or mass in the tummy area (abdomen). This can cause tummy pain, feeling sick (nausea)| and diarrhoea|.
If lymph nodes in the chest or throat are enlarged, this may cause a sore throat, difficulty swallowing or breathlessness|.
BL can also cause more general symptoms including night sweats, high temperatures and weight loss. These are called B-symptoms.
A diagnosis is made by removing a piece of tissue from the lump (tumour) or removing an enlarged lymph node. The tissue is then examined under a microscope. Depending on which area of the body is affected, this 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 done to find out more about the type of lymphoma and how far it has spread in the body. Doctors use this information to decide which treatment is most appropriate for you. You can read more about these tests in our general information about 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.
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: indolent (sometimes called low-grade) and aggressive (sometimes called high-grade). Indolent lymphomas are usually slow-growing, and aggressive lymphomas grow more quickly.
BL is an aggressive lymphoma. This means that it is fast-growing and usually needs treatment straight away 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 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 most appropriate for you.
Intrathecal chemotherapy 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, and 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 fitness 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 high-dose chemotherapy with stem cell support.
Some people may have treatment using stem cells from another person (a donor). This is called a donor (allogeneic) stem cell transplant|.
Steroids| are drugs which 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.
Lymphoma Association| gives emotional support, advice and information on all aspects of Hodgkin lymphoma and non-Hodgkin lymphoma. Has a national network of people with lymphoma and local groups.
Leukaemia CARE| is a national group that promotes the welfare of people with leukaemia and other blood disorders. Has regional support groups.
This section has been compiled using information from a number of reliable sources, including:
Thanks to Professor Rajnish Gupta, Consultant Medical Oncologist, and all of the people affected by cancer who reviewed this edition.
Reviewing information is just one of the ways you could help when you join our Cancer Voices network|.
Content last reviewed: 1 January 2013
Next planned review: 2015
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.
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© Macmillan Cancer Support 2013
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