The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

Skip to main content

Burkitt Lymphoma

Highly aggressive B-cell non-Hodgkin lymphoma with characteristic c-MYC translocation

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Hematoloji department. Book Appointment →

What is Burkitt Lymphoma?

Burkitt lymphoma (BL) is a highly aggressive B-cell non-Hodgkin lymphoma derived from germinal center B-cells, characterized by extraordinarily high proliferation rate (Ki-67 ≥95%) and translocations between the c-MYC oncogene on chromosome 8 and immunoglobulin gene loci. Three distinct clinical variants exist: endemic (eBL, predominantly in equatorial Africa, presenting with jaw/facial mass in children, strongly associated with EBV and chronic malaria), sporadic (sBL, worldwide distribution, presenting with abdominal mass in children and adults, intermediate EBV association), and immunodeficiency-associated (iBL, in HIV/AIDS patients, immunosuppression after transplantation, with intermediate EBV association).

Pathogenesis involves c-MYC translocation as defining genetic event: t(8;14)(q24;q32) IGH-MYC (75-85%), t(2;8)(p12;q24) IGK-MYC (10%), or t(8;22)(q24;q11) IGL-MYC (5-10%). Additional mutations in TP53, ID3, TCF3, and CCND3 are common. EBV infection plays cofactor role in endemic and immunodeficiency variants. Clinical features depend on variant: endemic BL with jaw, orbital, or facial mass progressing rapidly, sporadic BL with abdominal involvement (ileocecal mass, mesentery, ovaries, kidneys), B-symptoms, and central nervous system or bone marrow involvement, leukemic phase, tumor lysis syndrome (very common given rapid proliferation).

Diagnosis requires tissue biopsy with immunohistochemistry (CD20+, CD10+, BCL6+, BCL2-, Ki-67 ≥95%), FISH for c-MYC rearrangement, flow cytometry, cytogenetics, and exclusion of high-grade B-cell lymphoma with MYC and BCL2 or BCL6 rearrangements (double-hit lymphomas). Staging includes PET-CT, bone marrow biopsy, lumbar puncture for CSF examination, and laboratory studies including LDH, uric acid, electrolytes for tumor lysis monitoring. Treatment requires intensive chemotherapy with CNS prophylaxis: pediatric protocols (LMB-FAB, BFM) achieve cure in 90% of localized and 80-90% of advanced disease, adult regimens including DA-EPOCH-R (most common in US), CODOX-M/IVAC ± rituximab, hyper-CVAD/MA, with CNS prophylaxis using intrathecal methotrexate and cytarabine. Tumor lysis syndrome prevention with rasburicase, hydration, allopurinol is essential. Outcomes for high-risk and HIV-associated cases are improving with rituximab and antiretroviral therapy.

Symptoms

Rapidly enlarging mass (often within weeks)
Endemic: jaw or facial mass (children)
Endemic: orbital involvement
Sporadic: abdominal mass (often ileocecal)
Abdominal pain and distension
Bowel obstruction or perforation
Hepatomegaly
Splenomegaly
Lymphadenopathy
Pleural or pericardial effusions
B-symptoms: fever, night sweats, weight loss
Bone marrow involvement with cytopenias
Leukemic phase with circulating blasts
Renal involvement causing renal failure
Ovarian or testicular masses
CNS involvement (cranial neuropathy, paraplegia)
Tumor lysis syndrome features (hyperuricemia, hyperkalemia, hyperphosphatemia)
Acute renal failure from tumor lysis
Lactic acidosis
Disseminated intravascular coagulation

Risk Factors

Equatorial Africa residence (endemic variant)
Chronic malaria infection
Epstein-Barr virus (EBV) infection
HIV/AIDS infection
Solid organ transplantation
Stem cell transplantation
Immunosuppressive medications
Common variable immunodeficiency
Other primary immunodeficiency syndromes
Pediatric age (most common in childhood, but occurs in adults)
Male gender (slight predominance)
African ethnicity (endemic variant)
Family history of lymphoma (rare)
Prior chemotherapy or radiation
Genetic susceptibility factors
Holoendemic malaria zones
Equatorial climate exposure
Limited access to healthcare in endemic regions
Coexisting hepatitis B or C
Compromised T-cell function

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Rapidly growing mass in any location
  • Jaw or facial mass in child from endemic region
  • Abdominal mass with B-symptoms
  • Severe abdominal pain with distension
  • Bowel obstruction symptoms
  • Lymphadenopathy with constitutional symptoms
  • Pancytopenia with abnormal lymphoid cells
  • Lactate dehydrogenase elevation
  • Acute renal failure with mass on imaging
  • HIV/AIDS with lymphadenopathy
  • Post-transplant patient with mass
  • CNS symptoms with known lymphoma history
  • Tumor lysis syndrome features
  • Suspected lymphoma in immunocompromised patient
  • Rapidly worsening symptoms requiring urgent evaluation

Treatment Methods

01
Comprehensive evaluation by hematologist-oncologist with lymphoma expertise
02
Detailed history and physical examination
03
Tissue biopsy (excisional preferred over fine-needle aspiration)
04
Immunohistochemistry: CD20+, CD10+, BCL6+, BCL2-, Ki-67 ≥95%
05
FISH for c-MYC rearrangement (essential)
06
Flow cytometry for clonality and immunophenotyping
07
Cytogenetics for confirmation of t(8;14), t(2;8), or t(8;22)
08
Molecular studies for additional mutations
09
Exclusion of high-grade B-cell lymphoma (HGBL) with MYC/BCL2/BCL6
10
PET-CT for staging
11
Bone marrow biopsy and aspirate
12
Lumbar puncture for CSF cytology and flow cytometry
13
Laboratory studies: CBC, comprehensive metabolic panel, LDH
14
Tumor lysis labs: uric acid, potassium, phosphate, calcium, creatinine
15
HIV testing (essential)
16
Hepatitis B and C testing
17
Echocardiogram for cardiac function before anthracyclines
18
Pulmonary function testing if indicated
19
Tumor lysis syndrome prevention: rasburicase, allopurinol, IV hydration
20
Pediatric BL: LMB protocols (LMB-89, LMB-96)
21
Pediatric BL: BFM protocols
22
Adult BL: DA-EPOCH-R (dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin with rituximab) — most common in US
23
Adult BL: CODOX-M/IVAC (Magrath protocol) ± rituximab
24
Adult BL: hyper-CVAD/MA
25
CNS prophylaxis with intrathecal methotrexate and cytarabine
26
High-dose methotrexate or cytarabine for systemic CNS prophylaxis
27
Treatment intensity adjusted by risk stratification
28
HIV-associated BL: same protocols + concurrent ART
29
Burkitt leukemia (FAB L3 ALL): hyper-CVAD or pediatric protocols
30
Refractory or relapsed: salvage with R-ICE, R-DHAP, or transplantation
31
Allogeneic or autologous stem cell transplantation for selected cases
32
CAR-T cell therapy for refractory cases
33
Multidisciplinary care including hematology, infectious disease, nephrology
34
Long-term surveillance for relapse and late effects

Which Department to Visit?

You can visit our Hematoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Hematoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Related Health Topics

Other articles from the same department you may want to explore.

Burkitt Lymphoma: Detailed Diagnosis and Treatment

Hematoloji

Burkitt lymphoma is a highly aggressive mature B-cell non-Hodgkin lymphoma defined by MYC translocations and one of the fastest growing human tumors. Endemic, sporadic and immunodeficiency-associated forms differ in epidemiology, but cure is achievable with intensive multi-agent chemotherapy and central nervous system prophylaxis when treated promptly.

Anaemia

Dahiliye (İç Hastalıkları)

Anaemia is a low haemoglobin level that reduces oxygen delivery, causing fatigue, pallor, and shortness of breath. It is not a disease itself but a sign of many underlying conditions. Most cases are correctable with appropriate diagnosis and treatment.

Iron Deficiency Anaemia

Dahiliye (İç Hastalıkları)

Iron deficiency anaemia develops when dietary intake, absorption, or losses create an iron shortfall, most often affecting women and children. Identifying the underlying cause is the core of management, alongside iron replacement.

Vitamin B12 Deficiency

Dahiliye (İç Hastalıkları)

Vitamin B12 deficiency can cause megaloblastic anaemia, neurological symptoms, and cognitive impairment. Early treatment with intramuscular or oral B12 largely prevents irreversible complications.

Hypertension (High Blood Pressure) Management

Dahiliye (İç Hastalıkları)

Hypertension is often called the silent killer because it progresses symptom-free for years and can damage the heart, brain, kidneys, and eyes. Regular monitoring, lifestyle change, and evidence-based drug therapy dramatically reduce cardiovascular risk.

Chronic Kidney Disease

Dahiliye (İç Hastalıkları)

Chronic kidney disease is one of the most common complications of chronic conditions such as diabetes and hypertension, and can be silent in its early stages.

Hepatitis B (HBV)

Dahiliye (İç Hastalıkları)

Hepatitis B is a DNA virus infection causing acute and chronic hepatitis with risk of cirrhosis and hepatocellular carcinoma; diagnosis integrates HBsAg, HBeAg, anti-HBc, and HBV DNA with management based on disease phase using nucleos(t)ide analogues (entecavir, tenofovir) and universal infant vaccination.

Hepatitis C (HCV)

Dahiliye (İç Hastalıkları)

Hepatitis C is an RNA virus causing chronic hepatitis that may progress to cirrhosis and hepatocellular carcinoma; modern direct-acting antiviral (DAA) pangenotypic regimens (sofosbuvir/velpatasvir, glecaprevir/pibrentasvir) achieve sustained virologic response over 95% in 8–12 weeks with universal adult screening and cure for nearly all patients.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.