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Burkitt / Burkitt-like Lymphoma

Last update: 01/17/2014

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Overview of Burkitt's Lymphoma
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Burkitt are highly aggressive lymphomas.  As such, the goal of treatment is usually to cure the disease with aggressive therapy.   From OncologyChannel: "Small noncleaved cell lymphoma (SNCL) is a classification that, in general, has been replaced by the terms Burkitt lymphoma and Burkitt-like (or non-Burkitt) lymphoma. 

In children, most SNCLs are Burkitt lymphomas, whereas most adult SNCLs are Burkitt-like lymphomas.  Burkitt's lymphoma tends to occur most often in children and in adults with compromised immune systems. 

There are three distinct forms of this disease: endemic, sporadic, and immunodeficient.

Endemic Burkitt lymphoma is seen among the young of equatorial Africa. It frequently affects the jaws of children with developing molar teeth; experts suggest that growth factors may be responsible for the site-specific nature of this tumor. 

Sporadic Burkitt lymphoma often involves the abdomen, and it spreads to the bone marrow in about 20% of patients. 

Immunodeficient Burkitt lymphoma affects patients with abnormal immune systems (e.g., patients with HIV)." 

Source: oncologychannel.com 

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See NCCN.org guidelines, page 57 
for combination protocols used with curative intent, such as:

CALGB 9251 or CODOX-M, or HyperCVAD or dose-adjusted EPOCH
Protocols may be adjusted based on high or low risk disease.

(free registration required)

NCCN.org notes that CHOP-R is not adequate. 

In the News:

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Oncology Times 2014;
Burkitt Lymphoma: Low-Intensity Therapy Shown as Highly Effective http://bit.ly/1m64DRl
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Medscape 2013:
Burkitt's Yields to Longer-Duration, Lower-Dose Chemo http://bit.ly/Id5xxU
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Haematologica. 2013 Jun 10.: High cure rates in Burkitt lymphoma and leukemia: NILG study of the German short intensive rituximab-chemotherapy program. http://1.usa.gov/12AKHRQ 
bullet ARCHIVED under Treatments below.

 

Resources

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Overview cancerbackup.org.uk 
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Burkitts.org
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The Oncologist, 2006, Ferry: Burkitt’s Lymphoma: Clinicopathologic Features and Differential Diagnosis theoncologist
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Burkitt Lymphoma in Adults, Hematology 2008
 asheducationbook
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Blood, 2004, Blum: Adult Burkitt leukemia and lymphoma http://bloodjournal.hematologylibrary.org/content/104/10/3009.full
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Molecular diagnosis (to distinguish from DLBCL) nejm.org
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Burkitt’s Lymphoma: A Review of the Epidemiology  kma.org.pdf
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Burkitt-like lymphoma of T-cell type ncbi.nlm.nih.gov 
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The Burkitt-like lymphomas bloodjournal.hematologylibrary.org

Southwest Oncology Group study delineating phenotypic, genotypic, 
and clinical features 

 
Treatments

Treatments
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TOPIC SEARCH: PubMed: Review | Therapies | Outcomes

Related Resources and Reports

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The role of hematopoietic SCT in adult Burkitt lymphoma macopscomments.Article.pdf
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Evaluation of the addition of rituximab to CODOX-M/IVAC for Burkitt's lymphoma:  Life After Cancer | National Comprehensive Cancer Network 
http://bit.ly/qfDMrn 
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Evaluation of the addition of rituximab to CODOX-M/IVAC for Burkitt's lymphoma: a retrospective analysis annonc.oxfordjournals.org
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Efficacy and toxicity of dose-adjusted EPOCH-rituximab in adults with newly diagnosed Burkitt lymphoma, 2007 ascopubs.org
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Evaluation of the addition of rituximab to CODOX-M/IVAC for Burkitt's lymphoma: a retrospective analysis annonc.oxfordjournals.org
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Treatment of Burkitt's/Burkitt-like lymphoma in adolescents and adults: a 20-year experience from the Norwegian Radium Hospital with the use of three successive regimens  http://annonc.oxfordjournals.org
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ASH: Chemotherapy Regimen Induces Complete Remissions in Burkitt's 

By Neil Osterweil, Senior Associate Editor, MedPage Today
Published: December 11, 2006  .medpagetoday.com 

A novel approach to Burkitt's lymphoma, using a regimen designed for large B-cell lymphomas, led to complete remissions in all patients in a small study, investigators reported here. 

In a study of 19 patients with Burkitt's, the highly aggressive B-cell lymphoma, all 19 treated with dose-adjusted EPOCH with Rituxan (rituximab) had a complete remission, with few of the adverse events associated with standard chemotherapy for Burkitt's lymphoma, reported Kieron Dunleavy, M.D., of the National Cancer Institute in Bethesda, Md., and colleagues. 
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An international evaluation of CODOX-M and CODOX-M alternating with IVAC in adult Burkitt's lymphoma: results of United Kingdom Lymphoma Group LY06 study.
Ann Oncol. 2002 Aug;13(8):1264-74.  PMID: 12181251
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Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10.
PMID: 16284057 | Related articles
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Sequential doxorubicin and topotecan in relapsed/refractory aggressive Burkitt's / DLBCL: Results of CALGB 59906. Leuk Lymphoma. 2006 Aug;47(8):1511-7.  PMID: 16966261 

Five (of 26) patients (20%, 95% confidence interval 0.07, 0.42) responded with two (8%) complete remissions and three (12%) partial remissions; an additional four (16%) patients had stable disease. Both patients achieving a complete remission had Burkitt's lymphoma. There were no treatment-related deaths. In conclusion, the combination of doxorubicin and topotecan is well tolerated and has modest activity in relapsed/refractory NHL, with occasional patients having a prolonged remission. The activity in Burkitt's lymphoma should be investigated further.
ClinicalTrials.gov (easy and comprehensive) searches by
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All studies for Burkitt's listed in ClinicalTrials.gov 
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Other criteria such as age, stage, phase, refractory

 Research News

Research News
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Burkitt's Like Lymphoma in Patients with and Without Hiv Infection a report of 33 patients from north-east Italy  informaworld.com/ 
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Adult Burkitt's Leukemia and Lymphoma. 
Blood. 2004 Jul 20 [Epub ahead of print] PMID: 15265787
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Burkitt-like: translocations specific to HIV-infected men 
bloodjournal.hematologylibrary.org  .pdf
 
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Chemoimmunotherapy with hyper-CVAD plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia. Cancer. 2006 Feb 24; PMID: 16502413
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c-Flip protein expression in Burkitt's lymphomas is associated with a poor clinical outcome. Br J Haematol. 2005 Mar;128(6):767-73. PMID: 15755279
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High response rate and manageable toxicity with an intensive, short-term chemotherapy programme for Burkitt's lymphoma in adults. Br J Haematol. 2004 Sep;126(6):815-20. PMID: 15352985 | Related articles
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Modified magrath regimens for adults with Burkitt and Burkitt-like lymphomas: preserved efficacy with decreased toxicity. Leuk Lymphoma. 2004 Apr;45(4):761-7. PMID: 15160953
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Epstein-Barr virus (EBV) associated lymphomas  Related abstracts
The three main types of EBV-associated B-cell lymphoma are Burkitt lymphoma, Hodgkin lymphoma and post-transplant lymphomas
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Burkitt's lymphoma: single-centre experience with modified BFM protocol. Clin Lab Haematol. 2002 Apr;24(2):111-4. PMID: 11985557  PubMed
 
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