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Burkitt's lymphoma

Definition
Burkitt's lymphoma is a form of cancer that primarily affects children living in certain areas of Africa. Burkitt's lymphoma is also found in North America, but it is rare. Adults can also be affected. The disease also affects 8 in every 100,000 children in Papua New Guinea.

What is going on in the body? 
Burkitt's lymphoma occurs when a specialised white blood cell, the B-lymphocyte, undergoes cancerous changes. The cells begin to grow and multiply out of control. The cancerous cells form tumours. Burkitt's lymphoma is aggressive. Once it develops, it can grow quickly.

There are two types of Burkitt's lymphoma: the African form and the North American form. In the African form, tumours form under the jaw and in the abdomen. It is associated with an infection called Epstein-Barr virus. This is a common virus and most people recover from it. However, in African children Epstein-Barr virus causes cells to turn cancerous. No one is sure why. One theory is that children who have had malaria have weakened immune systems. This may make their bodies more likely to respond this way to an Epstein-Barr virus infection.

In the North American form of Burkitt's lymphoma, the bone marrow is affected. Epstein-Barr virus is not a factor in this form of the disease. In North America, Epstein-Barr infections are associated with mononucleosis.

What are the signs and symptoms of the disease? 
Symptoms of Burkitt's lymphoma in Africa include:
  • swelling of lymph nodes around the jaw
  • swelling of lymph nodes in the abdomen
  • unexplained weight loss
  • extreme fatigue
Symptoms of Burkitt's lymphoma in North America include:
  • being unable to fight infections. This is because the bone marrow undergoes cancerous changes and is unable to make cells to fight infection.
  • weight loss
  • fatigue
What are the causes and risks of the disease? 
The exact cause of Burkitt's lymphoma is unknown. Burkitt's lymphoma seems to happen most often in persons who first have had a condition that weakens their immune systems, such as malaria or AIDS. Then, when these people come down with Epstein-Barr virus, Burkitt's lymphoma occurs.

What can be done to prevent the disease? 
Nothing can be done to prevent this cancer.

How is the disease diagnosed? 
The disease is diagnosed by analysing a sample of cells from the swollen tissue in the jaw or abdomen. A piece of the swollen tissue, or biopsy sample, is removed. Special stains and other tests are applied to the tissue. If these tests show Burkitt's lymphoma, then the person will undergo other testing. This includes CT scans and a bone marrow biopsy to figure out the extent of the cancer.

What are the long-term effects of the disease? 
Burkitt's lymphoma is an aggressive cancer. Once it appears, the cancerous cells grow very quickly. If it is not treated, Burkitt's lymphoma leads to death.

What are the risks to others? 
There is no risk to others from a person with Burkitt's lymphoma or any other cancer.

What are the treatments for the disease? 
Chemotherapy is the primary treatment because the disease is usually spread all over the body. Several different types of chemotherapy are given together. The African form is the most treatable. Cancer is said to be in remission, with no evidence of disease, when it has been successfully treated. The remission in Burkitt's lymphoma may be long-lasting.

What are the side effects of the treatments? 
The side effects depend on the medications used to treat the cancer. After treatment is completed, the side effects go away. The most common side effects are nausea, fatigue, and being more likely to develop infections.

What happens after treatment for the disease? 
After treatment, the person will have to be monitored closely to make sure that the cancer doesn't come back. It is usually necessary to follow the person closely for the rest of his or her life.

How is the disease monitored? 
CT scans, special x-rays, and physical examinations are used to monitor the body's response to treatment. These same tests are also used to check if the disease has come back. Bloods tests, including a FBC, are used during treatment to monitor for side effects, such as low blood cell amounts.

Author: 
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 12/06/2005
Contributors
Potential conflict of interest information for reviewers available on request
 


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