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Burkitt Lymphoma: Treatments and Side Effects

Medically reviewed by Mark Levin, M.D.
Written by Maureen McNulty
Posted on July 1, 2022

Burkitt lymphoma is a type of non-Hodgkin lymphoma (NHL) that grows very quickly. People who are diagnosed with this type of blood cancer will need to begin treatment right away. This may mean being admitted to the hospital immediately. Although Burkitt lymphoma grows quickly, it also responds quickly to therapy. More than 90 percent of children and young adults with Burkitt lymphoma can be cured (have their lymphoma disappear and never return).

Deciding on a Treatment Plan

Treatment options for Burkitt lymphoma depend on a person’s disease stage and age. Stages of lymphoma describe how far in the body the cancer has spread. Additionally, doctors treat Burkitt lymphoma differently in children than in adults.

Doctors recommend different treatment options depending on whether a person has low-risk or high-risk Burkitt lymphoma. A person’s risk level describes how aggressive their disease is and how likely it is that their lymphoma will relapse (come back).

Doctors have several ways of dividing Burkitt lymphoma into risk groups. People with high-risk disease often have signs and symptoms such as:

  • High blood levels of lactate dehydrogenase
  • Advanced-stage lymphoma
  • Large tumors
  • General feelings of unwellness

They also may be HIV-positive. Doctors treat high-risk disease with more aggressive treatments.

Lymphoma treatments are also based on an individual’s personal preferences. Talk to your health care team to learn more about what to expect from different Burkitt lymphoma treatment options.

Treatments for Burkitt Lymphoma

People with Burkitt lymphoma most often receive a combination of chemotherapy and targeted therapy drugs. Different treatments may help cure Burkitt lymphoma, stop it from spreading, relieve symptoms, or prevent it from relapsing.

High-risk Burkitt lymphoma treatments are usually intensive (given at high doses). Doctors need to closely monitor people using these treatments. Any complications that arise need to be treated right away. People undergoing intensive chemotherapy treatments often need to stay in the hospital.

Chemotherapy for Children With Burkitt Lymphoma

Children with Burkitt lymphoma receive a combination of several chemotherapy drugs. These drugs often include:

Doctors give chemotherapy in cycles. Each cycle includes taking one or more drugs and then going through a rest period. Pediatric Burkitt lymphoma may be treated with between two to eight cycles of chemotherapy, depending on how advanced the cancer is. Once these cycles are complete, doctors may recommend additional chemotherapy drugs to help keep cancer from returning.

Chemotherapy for Adults With Burkitt Lymphoma

Adults with Burkitt lymphoma use different chemotherapy regimens (treatment plans). The regimen a person receives depends on their overall health and whether they have low-risk or high-risk disease. Regimens include:

  • Dose-adjusted EPOCH — Etoposide (Toposar), prednisone (Deltasone), vincristine, cyclophosphamide, and doxorubicin hydrochloride
  • Hyper-CVAD — Cyclophosphamide, vincristine, doxorubicin hydrochloride, dexamethasone, cytarabine (Cytosar), and high-dose methotrexate
  • CODOX-M/IVAC — CODOX-M (cyclophosphamide, doxorubicin, vincristine, cytarabine, and methotrexate), alternating with IVAC (ifosfamide, etoposide, and cytarabine)

Burkitt lymphoma can sometimes spread to the central nervous system (CNS), which includes the brain and spinal cord. If doctors find it there or suspect it, they may recommend intrathecal chemotherapy. During this treatment, called CNS prophylaxis, chemotherapy drugs are injected directly into the spinal fluid. This helps prevent cancer cells from spreading to the CNS.

Targeted Therapy

Most people with Burkitt lymphoma receive a targeted therapy called rituximab (Rituxan). Targeted therapy drugs are a form of immunotherapy — drugs that help the immune system fight cancer. They recognize and attack specific genes or proteins found on cancer cells.

Burkitt lymphoma develops in a type of white blood cell called a B lymphocyte. Rituximab targets a protein called CD20, which is found on B lymphocytes. Rituximab is usually added to the chemotherapy regimens listed above. This drug helps people with Burkitt lymphoma have better outcomes.

Surgery

Most people with Burkitt lymphoma do not need surgery. However, surgery can sometimes help remove a large tumor that is blocking the intestines or pressing on an organ. Doctors may also recommend surgery if a person has early-stage Burkitt lymphoma that has not spread. In this case, people would undergo surgery as their first treatment and then receive chemotherapy to remove any remaining lymphoma cells.

Clinical Trials

Researchers are studying potential new treatments for Burkitt lymphoma in clinical trials — research studies looking at the effectiveness of new treatments. For example, researchers are studying whether other targeted therapy drugs can also effectively kill Burkitt lymphoma cells. They’re also testing new chemotherapy regimens. If you’re interested in participating in cancer research and joining a clinical trial, talk to your doctor.

Treating Relapsed Burkitt Lymphoma

Treatments often effectively kill Burkitt lymphoma cells. However, there is always a chance that the lymphoma will relapse. People who’ve had Burkitt lymphoma should see their doctor for regular follow-up visits. During these visits, doctors check for signs that the lymphoma might have returned.

Doctors recommend chemotherapy drugs for people with relapsed Burkitt lymphoma. These chemotherapy regimens may be different from the ones that were used previously. Some people may also have the option of undergoing a stem cell transplant. During an autologous stem cell transplant, a person’s stem cells (cells that make new blood cells) are collected and then replaced after aggressive treatments. Alternatively, they can come from other donors, called an allogeneic stem cell transplant.

Managing Burkitt Lymphoma Treatment Side Effects

Chemotherapy drugs kill cancer cells — but they also damage healthy cells. This can lead to side effects. People undergoing high-dose chemotherapy may experience:

  • Pain
  • Extreme tiredness
  • Nausea or vomiting
  • Diarrhea
  • Constipation
  • Mouth sores
  • Nerve damage, leading to feelings of burning, weakness, or tingling
  • Problems remembering or focusing

The treatment of Burkitt lymphoma sometimes causes lasting health effects. Children with NHL are more likely to develop other types of cancer later in life. Occasionally, treatments such as chemotherapy can also affect fertility, making it difficult for a person to have children in the future.

Doctors use palliative treatments to reduce cancer symptoms and treatment side effects. Palliative care aims to support people living with chronic illness and improve their quality of life. Palliative treatments can be used with other aggressive treatments.

Tumor Lysis Syndrome

Some people with Burkitt lymphoma develop tumor lysis syndrome. This condition may occur if treatments work quickly and kill many tumor cells at once. As the tumor cells die, they break open, and the inside of the cells spill out into the blood and damage other tissues and organs.

Tumor lysis syndrome can be serious or even fatal. It causes symptoms like:

  • Nausea
  • Vomiting
  • Tiredness
  • Joint pain
  • Irregular heartbeat
  • Breathing problems
  • Cloudy urine

If tumor lysis syndrome isn’t immediately treated, it can cause serious health problems, such as seizures or kidney damage. Doctors treat tumor lysis syndrome by giving people extra fluids and prescribing drugs like allopurinol (Aloprim) or rasburicase (Elitek).

Talk With Others Who Understand

MyLymphomaTeam is the social network for people with lymphoma and their loved ones. On MyLymphomaTeam, more than 11,000 members come together to ask questions, give advice, and share their stories with others who understand life with lymphoma.

Are you living with Burkitt lymphoma? Share your experiences in the comments below, or start a conversation by posting on your Activities page.

Posted on July 1, 2022
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Mark Levin, M.D. is a hematology and oncology specialist with over 37 years of experience in internal medicine. Review provided by VeriMed Healthcare Network. Learn more about him here
Maureen McNulty studied molecular genetics and English at Ohio State University. Learn more about her here

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