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Burkitt lymphoma (BL) is a rare type of non-Hodgkin lymphoma (NHL). BL develops when B-cells become abnormal (cancerous). B-cells are white blood cells that normally help fight infection. They are sometimes called B-lymphocytes.
There are different types of BL:
- Sporadic BL – this is the most common type of BL. It usually develops in the tummy (abdomen), where it may form a large tumour. It can also affect other parts of the body.
- Immunodeficiency-related BL – this type develops in people who have a weakened immune system.
- Endemic BL – this type mainly affects children in Africa and is very rare in the UK.
BL is fast growing. You usually start treatment soon after diagnosis.
BL is more common in men than women. It mainly affects children, although it can affect people of all ages. This information is about BL in adults. If you need more information about lymphoma in children, you can visit the Children’s Cancer and Leukaemia Group website.
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BL commonly develops in the tummy area (abdomen). This can cause symptoms such as:
- tummy pain
- swelling of your tummy caused by a build-up of fluid (ascites)
- feeling sick (nausea)
BL may also cause painless swellings in the neck, armpit or groin. These are caused by lymphoma cells building up in the lymph nodes, which makes them bigger. Often lymph nodes in more than one part of the body are affected.
The symptoms of BL can often develop very quickly.
Some people also have symptoms that doctors call B symptoms. These can include:
- drenching night sweats which require a change of nightwear and bed covers
- high temperatures (fevers) with no obvious cause
- unexplained weight loss.
Knowing if you have any B symptoms will help your doctor to stage the lymphoma and plan your treatment.
Sometimes lymphoma cells may build up in the bone marrow, where blood cells are made. This can cause:
- anaemia – this is caused by the low number of red blood cells in your blood
- bruising or bleeding easily – this is caused by the low number of blood-clotting cells (platelets) in your blood.
General symptoms of BL may include loss of appetite and tiredness.
The causes of sporadic BL are mostly unknown. It is sometimes linked to the virus that causes glandular fever. This is called the Epstein-Barr virus (EBV). But it is important to remember that EBV is very common. Most people with EBV will not develop lymphoma.
Your risk of developing immunodeficiency-associated BL may be higher if your immune system is weak. Your immune system can be weakened by:
- conditions such as HIV
- drugs called immunosuppressants – these are used after an organ transplant, or to treat autoimmune disease.
Like other cancers, BL is not infectious. It cannot be passed on to other people.
The most common test for diagnosing lymphoma is a biopsy. A doctor will take a sample of tissue from the affected area. The most common place to take a biopsy from is an enlarged lymph node. This is called a lymph node biopsy. You may have all or a part of the lymph node removed. The tissue will be sent to a laboratory for testing. You may also have biopsies taken from other areas of your body.
You can find out more about further tests you may have in our information about non-Hodgkin lymphoma.
Waiting for test results can be difficult. You may find it helpful to talk to your family, friends or specialist nurse.
Your test results will help your doctors find out how many areas of your body are affected by lymphoma and where these areas are. This is called staging.
Lymphomas are also grouped as either low-grade or high-grade. Low-grade lymphomas are usually slow growing. High-grade lymphomas usually grow more quickly. Burkitt lymphoma (BL) is a high-grade lymphoma.
Knowing the stage and grade of the lymphoma helps your doctor plan the right treatment for you.
We have more information about the stages and grades of non-Hodgkin lymphoma.
A team of specialists will meet to discuss the best possible treatment for you. They are called a multidisciplinary team (MDT).
Your doctor, cancer specialist or nurse will explain the different treatments and their side effects to you. They will also talk to you about things to consider when making treatment decisions.
Treatment for Burkitt lymphoma (BL) depends on the stage of the lymphoma and if you have symptoms that are causing problems.
These are the most common treatments for BL.
Immunotherapy and chemotherapy
BL is often treated with a combination of the immunotherapy drug rituximab and chemotherapy. Treatment is often very intensive and may take a few months. You may have to stay in hospital for much of this time.
Different combinations of chemotherapy may be used with rituximab, such as:
You may have some treatments as part of a clinical trial.
The drugs used to treat BL may cause the lymphoma cells to break down very quickly. This can cause chemical imbalances in the blood that affect the kidneys and the heart. This is called tumour lysis syndrome (TLS). Your doctor and nurse will monitor you closely for signs of TLS and give you drugs to help prevent it. You usually have a drug called rasburicase as a drip (infusion) and extra fluids as a drip to help protect your kidneys. You may only need rasburicase with the first treatment for BL. After that, you can have tablets called allopurinol instead.
The drugs used may cause the lymphoma cells to break down very quickly. This can cause chemical imbalances in the blood that affect the kidneys and the heart. This is called tumour lysis syndrome (TLS).
After treatment, some people are cured of BL. But for others, the lymphoma may come back after treatment. We have more information about treating lymphoma that has come back.
You will have regular follow-up appointments after your treatment. You can talk to your doctor or nurse about any concerns you may have at these appointments. Your doctor will want to know how you are feeling, and to check you are recovering from any side effects of treatment.
Sometimes side effects may continue or develop months or years after treatment. These are called late effects. We have more information about long-term and late effects of treatment for lymphoma.
Everyone has their own way of dealing with illness and the different emotions they experience. You may find it helpful to talk things over with family and friends or your doctor or nurse.
Macmillan is also here to support you. If you would like to talk, you can:
The organisations below also offer information and support:
Blood Cancer UK
Lymphoma Action gives emotional support, advice and information for people with Hodgkin lymphoma or non-Hodgkin lymphoma and those close to them. It has a national network of people with lymphoma, as well as local groups. Their website has a section called trialslink where you can see information about lymphoma clinical trials.
Below is a sample of the sources used in our Burkitt lymphoma (BL) information. If you would like more information about the sources we use, please contact us at email@example.com
National Institute of Health and Care Excellence (NICE). Blood and bone marrow cancers. NICE Pathways. Last accessed 3 December 2020.
Auer. R, Cook. L et al. Pan-London Haemato-Oncology Clinical Guidelines. Lymphoid Malignancies. Part 5: Less common lymphoid malignancies. January 2020. Available here: Pan-London-Less-Common-Guidelines-Jan-2020.pdf (rmpartners.nhs.uk).
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Anne Parker, Consultant Haematologist.
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