What is Burkitt Lymphoma? Early Signs, Risk Factors, and Treatment Explained

A diagnosis of Burkitt lymphoma can be an overwhelming experience, filled with
questions about a disease you may have never heard of. This comprehensive guide is
designed to provide clear, compassionate, and authoritative information to help you
understand what Burkitt lymphoma is, how it is diagnosed and treated, and what to
expect on your journey. We will use simple, patient-friendly language to ensure you feel
informed and empowered to navigate this challenge with confidence and hope.

What Is Burkitt Lymphoma?

Burkitt lymphoma is a very rare and highly aggressive type of B-cell non-Hodgkin lymphoma. It is a cancer of the lymphatic system, which is a network of tissues and organs that helps your body fight off infections. In Burkitt lymphoma, a specific type of immune cell called a B-lymphocyte becomes cancerous and multiplies uncontrollably. What makes Burkitt lymphoma unique is its incredibly rapid growth rate. It is one of the fastest-growing human tumors, with a doubling time of just 24 hours. Because of this, it can go from a small lump to a large, life-threatening mass in a very short period, often in a matter of weeks. While this rapid growth is frightening, it is also what makes the cancer highly sensitive to chemotherapy. With timely and aggressive treatment, Burkitt lymphoma has a high cure rate.

Types of Burkitt Lymphoma

Burkitt lymphoma is classified into three main subtypes based on where the cancer is
found and the patient’s immune system status.

● Endemic Burkitt Lymphoma: This type is most common in certain parts of
Africa. It is often linked to the Epstein-Barr virus (EBV) and frequently presents
as a tumor in the jaw or facial bones of young children. Malaria is also believed to
play a role in this subtype.
● Sporadic Burkitt Lymphoma: This is the type most commonly found in the
United States and other Western countries. It usually affects the abdomen, often
presenting as a large mass in the bowel or other abdominal organs. It can also|
appear in the lymph nodes or ovaries. The median age of diagnosis is around 30,
but it can occur at any age.
● Immunodeficiency-Related Burkitt Lymphoma: This subtype is seen in people with weakened immune systems, such as those with HIV/AIDS or those who have had an organ transplant and are taking immunosuppressant medications. It can affect the lymph nodes, bone marrow, and central nervous system.

What Are the Causes and Risk Factors for Burkitt Lymphoma?

The exact cause of Burkitt lymphoma is not fully understood, but it is known to be
caused by a specific genetic change in the cancer cells that leads to the over-expression
of a gene called MYC. This MYC gene, in combination with other risk factors, causes the
B-cells to grow and divide uncontrollably.

Key Risk Factors:

1. Weakened Immune System: A compromised immune system is a major risk
factor for Burkitt lymphoma. This includes people with HIV/AIDS, those who have had
an organ transplant and are on immunosuppressant drugs, and people with congenital
immune deficiencies.

2. Viral Infections:

● Epstein-Barr Virus (EBV): EBV is a very common virus that causes
mononucleosis (“mono”). In endemic Burkitt lymphoma, EBV is found in almost
all tumor cells. It is also linked to a significant number of immunodeficiency-
related cases.
● Human Immunodeficiency Virus (HIV): HIV weakens the immune system,
making a person more susceptible to developing Burkitt lymphoma, often in
combination with the Epstein-Barr virus.

3. Malaria: In the parts of Africa where endemic Burkitt lymphoma is common,
repeated bouts of malaria are believed to weaken the immune system, making it more
vulnerable to the effects of the Epstein-Barr virus.

It’s important to remember that most people who have these risk factors will never
develop Burkitt lymphoma.

What Are the Symptoms of Burkitt Lymphoma?

Because Burkitt lymphoma grows so quickly, its symptoms tend to appear suddenly and
can worsen rapidly. The symptoms depend on where the cancer is located.

Common Symptoms of Sporadic Burkitt Lymphoma (in the West):

● Abdominal Pain and Swelling: This is the most common symptom, caused
by a rapidly growing mass in the abdomen.
● Gastrointestinal Issues: Nausea, vomiting, diarrhea, and a feeling of fullness
after eating a small amount of food.
● Bowel Obstruction: If the tumor blocks the bowel, it can be a medical
emergency.
Common Symptoms of Endemic Burkitt Lymphoma (in Africa):
● Jaw or Facial Swelling: A rapidly growing mass in the jaw or face.
● Swelling Around the Eyes: This can also be a symptom of cancer.

Common Symptoms of Immunodeficiency-Related Burkitt Lymphoma:

● Swollen Lymph Nodes: Swollen lymph nodes in the neck, armpit, or groin.
● Fever: An unexplained fever that comes and goes.
● Night Sweats: Drenching night sweats.
● Unexplained Weight Loss: Losing weight without trying.
It is crucial to seek immediate medical attention if you notice a rapidly growing lump or
mass, especially if it is accompanied by other symptoms.

How Is Burkitt Lymphoma Diagnosed?

Due to the rapid nature of Burkitt lymphoma, the diagnosis must be made quickly. The
diagnostic process is a race against time and is often expedited to begin treatment as
soon as possible.

Diagnostic Steps and Tests:

1. Physical Exam and Medical History: Your doctor will perform a physical
exam to check for any lumps or swollen lymph nodes. They will also ask about
your symptoms and any risk factors, such as a history of HIV or travel to Africa.
2. Biopsy (The Definitive Step): A biopsy is the only way to definitively
diagnose Burkitt lymphoma. A tissue sample is taken from the suspicious area,
such as a lymph node or an abdominal mass, and sent to a lab for examination.
The pathologist will look for specific features of Burkitt lymphoma cells, such as
their high rate of cell division, and will perform genetic testing to confirm the
MYC gene translocation.
3. Blood Tests: Blood tests are crucial for diagnosis and monitoring. They can
show a high level of lactate dehydrogenase (LDH), an enzyme that is often
elevated in fast-growing cancers, and uric acid. Blood tests can also check for
infections like HIV and EBV.
4. Imaging Scans: Imaging tests are used to see how far the cancer has spread. A
CT scan provides detailed images of the chest, abdomen, and pelvis to see the
extent of the cancer. A PET scan can be very helpful as it can identify active
cancer cells throughout the body.
5. Bone Marrow Aspiration and Biopsy: A sample of bone marrow is taken
from the hip bone to check if the cancer has spread to the bone marrow. This is
an important step for staging.
6. Lumbar Puncture (Spinal Tap): Because Burkitt lymphoma can spread to
the central nervous system, a lumbar puncture is often performed to check for
cancer cells in the fluid that surrounds the brain and spinal cord.

Staging and Grading of Burkitt Lymphoma

All Burkitt lymphoma is considered a “high-grade” and aggressive cancer. Therefore, it
is not “graded” in the traditional sense. The key to treatment planning is “staging,”
which determines the extent of the cancer’s spread. The Ann Arbor staging system is
commonly accepted and widely used till date. It is divided into two types, low risk and
high risk.
● Stage I: The cancer is confined to one lymph node area or a single organ.
● Stage II: The cancer is in two or more lymph node areas on the same side of the
diaphragm (the muscle that separates the chest and abdomen).
● Stage III: The cancer is in lymph node areas on both sides of the diaphragm.
● Stage IV: The cancer has spread to distant parts of the body, such as the bone
marrow or central nervous system.

What Are the Treatment Options for Burkitt Lymphoma?

The treatment for Burkitt lymphoma must be immediate and aggressive. Due to its rapid
growth, it is considered a medical emergency. The good news is that this rapid growth
also makes the cancer highly responsive to chemotherapy, leading to high cure rates.

1. Medical Treatment (Chemotherapy and Immunotherapy)

● Chemotherapy: Chemotherapy is the primary treatment for Burkitt lymphoma.
It is given in short, intensive cycles to kill the cancer cells. The goal is to achieve a
complete remission.
● Intrathecal Chemotherapy: Because the cancer can spread to the central
nervous system, chemotherapy drugs are often injected directly into the fluid that
surrounds the brain and spinal cord to prevent or treat this spread.
● Immunotherapy: A targeted immunotherapy drug called Rituximab, which
targets a protein on B-cells, is now a standard part of Burkitt lymphoma
treatment. It is given with chemotherapy and has been shown to improve survival
rates.

2. Radiation Therapy

Radiation therapy is not a primary treatment for Burkitt lymphoma and is rarely used. It
may be used in specific cases to relieve symptoms, such as a large tumor that is pressing
on a vital organ, but it is not a part of the standard curative treatment.

3. Surgery

Surgery is not used as a primary treatment for Burkitt lymphoma because the cancer is
often widespread. A surgeon may remove a large mass that is causing a blockage, but the
main treatment will still be chemotherapy.

Prognosis and Survival Rates for Burkitt Lymphoma

The prognosis (the likely outcome of the disease) for Burkitt lymphoma has improved
dramatically in recent decades. The outlook depends on the patient’s age and overall
health, and how well the cancer responds to initial treatment.

● Prognostic Factors: The most important factors affecting prognosis are the
patient’s age, the stage of the cancer, and whether the cancer has spread to the
central nervous system.
● Survival Rates: The survival rate for Burkitt lymphoma is very high with
modern, intensive treatment. For children, the 5-year survival rate is now over
90%. For adults, the rate is lower, but still very positive, at around 60-70%.

It is important to discuss your specific prognosis with your hematologist (a doctor who
specializes in blood diseases), as they can provide a more accurate picture based on your
individual case.

Screening and Prevention of Burkitt Lymphoma

There are no routine screening tests for Burkitt lymphoma. The best way to reduce your
risk is to avoid known risk factors.

Prevention Strategies:

● HIV Prevention: If you are at risk for HIV, practice safe sex and avoid sharing
needles to reduce your risk of immunodeficiency-related Burkitt lymphoma.
● Healthy Immune System: For people with a weakened immune system, it is
crucial to work with your doctor to manage your health and be vigilant for any
unusual symptoms.

For International Patients: Your Seamless Journey to Apollo Hospitals

Apollo Hospitals is a leading medical destination for international patients seeking high-
quality and affordable cancer care. Our dedicated International Patient Services team is
here to ensure your entire experience is as smooth and comfortable as possible, from
your initial inquiry to your return home. We have extensive experience treating patients
with complex conditions, including Burkitt lymphoma.

Our Services for International Patients Include:

● Travel and Visa Assistance: We will provide you with a visa invitation letter
and help with travel arrangements.
● Airport Transfers: We will arrange for a car to pick you up from the airport.
● Personalized Care: A dedicated patient coordinator will be your single point of
contact, assisting with hospital admission, language interpretation, and any other
needs you may have.
● Accommodation: We can assist you with booking suitable accommodation for
you and your family near the hospital.
● Post-Treatment Follow-up: We will stay in touch with you after your return
home to ensure a smooth recovery.

About Apollo Proton Cancer Centre

Apollo Proton Cancer Centre (APCC) is the first proton therapy centre in India. APCC
has a fully integrated treatment suite that offers the most advanced treatment in
surgical, radiation and medical oncology procedures. True to the Apollo Pillars of
Expertise and Excellence, the Centre brings together a powerful team of clinicians
renowned globally for cancer care.
At Apollo Proton Cancer Centre (APCC), we combine advanced technology with globally
renowned clinical expertise to deliver superior outcomes and improved quality of life to
our patients.