{
  "schemaVersion": 2,
  "eyebrow": "Hematologic Oncology",
  "title": "Burkitt Lymphoma",
  "summary": "Burkitt lymphoma requires urgent expert confirmation, staging that specifically interrogates marrow and cerebrospinal fluid, tumor-lysis planning, and prompt rituximab-containing multiagent therapy with central nervous system-directed treatment selected by disease risk and CNS involvement.",
  "seoDescription": "Point-of-care guide to adult Burkitt lymphoma diagnosis, staging, CNS assessment, tumor lysis planning, and rituximab-based treatment selection.",
  "clinicalQuestion": "How should physicians rapidly confirm, stage, and treat adult Burkitt lymphoma while addressing tumor lysis and CNS risk?",
  "specialty": "Hematology-Oncology",
  "audience": "U.S. physicians and medical trainees",
  "tags": [
    "Burkitt lymphoma",
    "adult Burkitt lymphoma",
    "MYC rearrangement",
    "DA-EPOCH-R",
    "CODOX-M IVAC",
    "CNS prophylaxis",
    "tumor lysis syndrome"
  ],
  "keyTakeaways": [
    "Treat suspected Burkitt lymphoma as an oncologic urgency because of rapid tumor growth; obtain diagnostic tissue and initiate staging and treatment planning without avoidable delay. [1][23]",
    "A MYC rearrangement is characteristic of Burkitt lymphoma, but morphology and the full pathologic differential are necessary to separate it from high-grade B-cell lymphomas with MYC rearrangement. [15][18][20][21]",
    "Staging should include assessment for marrow and CNS disease; pretreatment cerebrospinal-fluid flow cytometry can determine the intensity of intrathecal methotrexate scheduling in a risk-adapted DA-EPOCH-R strategy. [24]",
    "Rituximab-containing multiagent chemoimmunotherapy is standard; in adults, rituximab added to highly dose-intensive chemotherapy improved 3-year event-free survival from 62% to 75% in a randomized study. [14][22]",
    "CNS-directed therapy is integral to most intensive Burkitt regimens; risk-adapted DA-EPOCH-R omitted CNS prophylaxis only for a defined low-risk group. [12][23][24]"
  ],
  "sections": [
    {
      "id": "urgent-triage-and-diagnostic-confirmation",
      "eyebrow": "First Decisions",
      "heading": "Act urgently while securing an expert hematopathologic diagnosis",
      "intro": "The immediate priorities are diagnostic tissue, tumor-burden assessment, and prevention of treatment-related metabolic complications.",
      "paragraphs": [
        "Burkitt lymphoma is a highly aggressive B-cell non-Hodgkin lymphoma with rapid tumor growth and frequent abdominal, jaw, or CNS involvement. Escalate suspected disease immediately to a lymphoma-directed hematology-oncology team; do not use a prolonged diagnostic observation interval when imaging or clinical trajectory suggests rapidly progressive disease. [1][23]",
        "Obtain adequate tissue for morphology, immunophenotyping, and cytogenetic or molecular testing for MYC rearrangement. MYC rearrangements are considered universal in Burkitt lymphoma, including HIV-associated disease, but MYC-rearranged aggressive B-cell neoplasms also include entities with clinicopathologic features distinct from Burkitt lymphoma. A pathology conclusion of Burkitt lymphoma should therefore integrate morphology with the exclusion of high-grade B-cell lymphoma, not otherwise specified, and other MYC-rearranged high-grade B-cell lymphomas rather than relying on MYC testing alone. [15][18][20][21]",
        "During diagnostic acceleration, evaluate symptoms or signs of bowel compromise, bulky abdominal disease, neurologic involvement, and high tumor burden because these findings affect treatment setting and CNS evaluation. Burkitt lymphoma is associated with high cell turnover and extensive FDG avidity; FDG-PET/CT is routinely used for staging, although the prognostic role of response PET remains less certain. [7]"
      ],
      "bullets": [
        "Request hematopathology review when a biopsy is reported as Burkitt-like, MYC-rearranged diffuse large B-cell lymphoma, or high-grade B-cell lymphoma; classification changes the intensity and CNS components of treatment. [20][21]",
        "Use FDG-PET/CT for baseline staging when feasible; Burkitt lymphoma is generally FDG avid because of high cellular turnover. [7]",
        "Test for HIV at diagnosis and coordinate lymphoma treatment with antiretroviral management when positive; HIV-associated Burkitt lymphoma remains clinically relevant despite antiretroviral therapy. [15][23]"
      ],
      "subsections": [],
      "table": {
        "caption": "Diagnostic distinctions that should prompt pathology-directed treatment planning. [15][18][20][21]",
        "columns": [
          "Finding",
          "Interpretation",
          "Next action"
        ],
        "rows": [
          [
            "MYC rearrangement with compatible Burkitt morphology",
            "Supports Burkitt lymphoma; MYC rearrangement is characteristic of the disease. [15][18]",
            "Complete staging rapidly and plan intensive rituximab-containing therapy with CNS assessment. [14][23]"
          ],
          [
            "MYC rearrangement but pathologic features inconsistent with Burkitt lymphoma",
            "Consider another aggressive MYC-rearranged B-cell neoplasm, including high-grade B-cell lymphoma. [20][21]",
            "Obtain expert hematopathology reconciliation before assigning a Burkitt-specific regimen. [20][21]"
          ],
          [
            "Known HIV infection",
            "Classifies disease as immunodeficiency-related Burkitt lymphoma when diagnostic criteria are met; morphology is not distinct from endemic or sporadic disease. [15]",
            "Assess immune status and deliver lymphoma-directed therapy with HIV management rather than withholding curative-intent treatment solely because of HIV. [15][23]"
          ]
        ]
      }
    },
    {
      "id": "staging-cns-and-risk",
      "eyebrow": "Staging",
      "heading": "Define marrow, cerebrospinal fluid, and systemic risk before selecting CNS therapy",
      "intro": "CNS and marrow involvement materially affect regimen delivery and prognosis.",
      "paragraphs": [
        "Perform systemic staging with FDG-PET/CT and obtain marrow evaluation when clinically indicated for disease definition. In the multicenter risk-adapted DA-EPOCH-R study, pretreatment CSF flow cytometry was incorporated specifically to identify CSF involvement and guide intrathecal methotrexate intensity. [7][24]",
        "Obtain cerebrospinal fluid for cytology and flow cytometry before systemic therapy when safely feasible, particularly when there are neurologic findings or substantial systemic disease. A positive CSF assessment changes management from prophylactic to active CNS-directed treatment in the DA-EPOCH-R approach. [24]",
        "Do not equate absence of neurologic symptoms with absence of CNS risk. Intensive Burkitt regimens incorporate CNS prophylaxis because CNS relapse prevention is a core treatment requirement; the major exception in the risk-adapted DA-EPOCH-R trial was a prespecified low-risk group treated without CNS prophylaxis. [12][23][24]",
        "Marrow or peripheral blood involvement identifies a higher-risk subgroup in the DA-EPOCH-R study. Among high-risk patients without CSF involvement, 4-year event-free survival was 66.7% with marrow or peripheral involvement versus 92.4% without either finding, supporting explicit documentation of these sites before finalizing risk discussions and treatment intensity. [24]"
      ],
      "bullets": [
        "Document baseline CNS status with CSF flow cytometry before choosing prophylactic versus therapeutic intrathecal treatment. [24]",
        "Record marrow and peripheral blood involvement separately because they affected outcomes in the risk-adapted DA-EPOCH-R cohort. [24]",
        "Use baseline PET/CT as the comparison study if interim imaging will be used; in the DA-EPOCH-R high-risk protocol, PET was performed after two cycles. [24]"
      ],
      "subsections": [],
      "table": {
        "caption": "CNS-directed decisions in the risk-adapted DA-EPOCH-R study. [24]",
        "columns": [
          "Clinical state",
          "CSF-directed action",
          "Systemic treatment framework"
        ],
        "rows": [
          [
            "Defined low-risk disease",
            "No CNS prophylaxis in the study's risk-adapted strategy. [22][24]",
            "Fewer DA-EPOCH-R cycles were used than for high-risk disease. [22][24]"
          ],
          [
            "High-risk disease without CNS involvement",
            "Intrathecal methotrexate on days 1 and 5 of cycles 3 through 6, totaling eight doses. [24]",
            "Six cycles of DA-EPOCH-R; PET after two cycles. [24]"
          ],
          [
            "CSF involvement",
            "Use active CNS therapy rather than a prophylaxis schedule. [24]",
            "High-risk DA-EPOCH-R framework with CNS treatment intensity determined by CSF involvement. [24]"
          ]
        ]
      }
    },
    {
      "id": "initial-management-and-tumor-lysis-planning",
      "eyebrow": "Treatment Readiness",
      "heading": "Prepare for tumor lysis and intensive-treatment toxicity before cytotoxic therapy",
      "intro": "Rapidly proliferative disease creates a narrow window for supportive planning.",
      "paragraphs": [
        "Plan initial treatment in a setting capable of frequent clinical and laboratory reassessment when disease burden is high or metabolic instability is anticipated. The high cellular turnover of Burkitt lymphoma and the high-intensity regimens used for treatment make tumor lysis planning and early monitoring operational priorities; DA-EPOCH-R has been described as feasible in an outpatient setting, including often during cycle 1, because of a low reported tumor-lysis risk in that strategy. [7][22]",
        "Before selecting a dose-intensive regimen, assess physiologic tolerance and the likelihood of infectious and hematologic toxicity. High-intensity Burkitt regimens carry significant hematologic toxicity and severe infection risk; older adults and patients with HIV more often require dose modifications with highly dose-intensive treatment. [23][24]",
        "For HIV-associated Burkitt lymphoma, do not substitute a less effective approach solely because HIV is present. High-dose chemotherapy has become feasible in the antiretroviral era, and CODOX-M/IVAC with rituximab has been reported to allow excellent immunologic recovery in HIV-associated Burkitt lymphoma. Regimen selection should still account for immune status, systemic disease, CNS involvement, and anticipated treatment tolerance. [10][11][15][23]"
      ],
      "bullets": [
        "Choose inpatient versus outpatient delivery based on tumor burden, metabolic risk, organ function, and the regimen's monitoring demands; outpatient DA-EPOCH-R experience should not be extrapolated automatically to all intensive regimens. [22][24]",
        "Establish an infection-monitoring plan before dose-intensive therapy because severe infection and hematologic toxicity are recognized regimen-related hazards. [23]",
        "Coordinate HIV and lymphoma management at treatment initiation; HIV-associated disease is not morphologically distinct and is treated with curative intent. [15][23]"
      ],
      "subsections": [],
      "table": {
        "caption": "Regimen-selection tradeoffs supported by adult Burkitt lymphoma literature. [22][23][24]",
        "columns": [
          "Treatment approach",
          "Potential advantage",
          "Key implementation issue"
        ],
        "rows": [
          [
            "Highly dose-intensive rituximab-containing multiagent therapy, including CODOX-M/IVAC-based approaches",
            "Established effective approach for Burkitt lymphoma and a standard multiagent chemoimmunotherapy strategy. [2][10][14]",
            "Requires readiness for substantial hematologic toxicity, severe infection risk, and CNS-directed treatment. [12][23]"
          ],
          [
            "Risk-adapted DA-EPOCH-R",
            "Infusional approach designed to reduce high peak drug concentrations; reported as less complex, less costly, and less toxic than some intensive strategies. [22][24]",
            "Requires formal risk assignment, pretreatment CSF flow cytometry, and protocol-specific intrathecal methotrexate scheduling for high-risk disease. [24]"
          ],
          [
            "DA-EPOCH-R in older adults or HIV-associated disease",
            "A less intensive alternative may be useful when aggressive regimens are poorly tolerated. [23]",
            "Do not omit CNS evaluation or CNS-directed treatment merely because a lower-intensity systemic platform is selected. [23][24]"
          ]
        ]
      }
    },
    {
      "id": "definitive-chemoimmunotherapy",
      "eyebrow": "Definitive Therapy",
      "heading": "Use rituximab-containing multiagent therapy and match CNS treatment to risk",
      "intro": "Curative treatment is systemic chemoimmunotherapy, not localized therapy alone.",
      "paragraphs": [
        "Use rituximab-containing multiagent chemoimmunotherapy as the treatment backbone. A randomized adult study found that adding rituximab to highly dose-intensive chemotherapy improved 3-year event-free survival to 75% (95% CI, 66% to 82%) versus 62% (95% CI, 53% to 70%) with chemotherapy alone. [14][22]",
        "CODOX-M/IVAC is a commonly cited intensive regimen for Burkitt lymphoma, and CNS prophylaxis is required in this treatment framework. Its clinical tradeoff is established activity against the substantial acute toxicity burden of high-intensity chemotherapy, including hematologic toxicity and severe infection. [2][12][23]",
        "Risk-adapted DA-EPOCH-R is an adult alternative with prospective multicenter data. High-risk patients received six cycles, with rituximab on day 1, and underwent PET after two cycles. Those without CNS involvement received intrathecal methotrexate on days 1 and 5 of cycles 3 through 6; patients with CSF involvement received active CNS therapy. [24]",
        "Do not use treatment response imaging alone to de-escalate CNS-directed care outside the regimen-specific approach. The cited DA-EPOCH-R protocol used baseline CSF flow cytometry to determine intrathecal treatment intensity and used interim PET after cycle 2 in high-risk disease; this is a structured risk-adapted pathway rather than evidence that PET replaces CNS staging. [22][24]"
      ],
      "bullets": [
        "Select an intensive CODOX-M/IVAC-based approach when the patient can tolerate its toxicity profile and institutional experience supports safe delivery. [2][10][12][23]",
        "Consider risk-adapted DA-EPOCH-R when a lower peak-intensity infusional strategy is preferred, while preserving protocol-based CSF assessment and intrathecal therapy for high-risk disease. [22][24]",
        "Treat confirmed CSF involvement as active CNS disease, not as an indication for prophylaxis alone. [24]"
      ],
      "subsections": [],
      "table": {
        "caption": "Practical treatment framework for adults with confirmed Burkitt lymphoma. [14][22][23][24]",
        "columns": [
          "Decision point",
          "Action",
          "Reason"
        ],
        "rows": [
          [
            "Patient eligible for intensive curative therapy",
            "Use rituximab-containing multiagent chemoimmunotherapy. [14][22]",
            "Rituximab improved 3-year event-free survival when added to highly dose-intensive chemotherapy. [22]"
          ],
          [
            "CODOX-M/IVAC-based strategy selected",
            "Include CNS prophylaxis as part of the regimen framework. [12]",
            "CNS prophylaxis is identified as required in Burkitt lymphoma treatment. [12][23]"
          ],
          [
            "Risk-adapted DA-EPOCH-R selected; high-risk and CSF negative",
            "Give intrathecal methotrexate on days 1 and 5 of cycles 3 to 6. [24]",
            "The protocol delivered eight prophylactic doses. [24]"
          ],
          [
            "Risk-adapted DA-EPOCH-R selected; CSF positive",
            "Escalate to active CNS-directed treatment. [24]",
            "Positive CSF disease alters intrathecal treatment intent and intensity. [24]"
          ]
        ]
      }
    },
    {
      "id": "monitoring-and-prognosis",
      "eyebrow": "Monitoring",
      "heading": "Monitor early toxicity, assess protocol-defined response, and focus follow-up on the first year",
      "intro": "Monitoring intensity should reflect both regimen toxicity and the early relapse pattern.",
      "paragraphs": [
        "During therapy, monitor for hematologic toxicity and severe infection, the principal adverse-effect categories associated with high-intensity Burkitt regimens. Dose-intensive therapy in older adults and in patients with HIV may require modification, but modification should follow an explicit reassessment of toxicity and treatment tolerance rather than routine preemptive de-intensification. [23][24]",
        "If using the high-risk DA-EPOCH-R pathway, obtain PET after two cycles as specified in the multicenter protocol. Interpret interim imaging within the planned regimen and alongside clinical status and marrow or CSF findings; the evidence excerpt identifies PET as a staging modality and protocol response assessment but does not establish PET as a replacement for direct CNS or marrow evaluation. [7][24]",
        "Counsel survivors that durable remission is strongly associated with remaining event-free through the first year in endemic Burkitt lymphoma, where relapse risk after one year is reported as 5% or less. This time-based estimate should not be generalized without qualification to every adult sporadic or HIV-associated population, but it supports concentrated clinical vigilance early after treatment completion. [23]"
      ],
      "bullets": [
        "Reassess infectious complications and hematologic recovery throughout intensive treatment; these toxicities may determine whether treatment modification is necessary. [23][24]",
        "In HIV-associated disease, follow immune recovery while delivering planned lymphoma therapy; excellent immunologic recovery has been reported after rituximab-containing CODOX-M/IVAC. [10][11]",
        "Use the first post-treatment year as the highest-yield period for relapse surveillance and symptom-triggered reassessment. [23]"
      ],
      "subsections": [],
      "table": {
        "caption": "Monitoring priorities by treatment phase. [7][10][11][23][24]",
        "columns": [
          "Phase",
          "Monitor",
          "Action if abnormal"
        ],
        "rows": [
          [
            "Pretreatment",
            "Tumor burden, CNS status by CSF flow cytometry, marrow or peripheral blood involvement, and treatment tolerance. [24]",
            "Assign risk and choose prophylactic versus active CNS-directed treatment. [24]"
          ],
          [
            "During intensive chemoimmunotherapy",
            "Hematologic toxicity and severe infection. [23]",
            "Reassess dose tolerance and supportive management; older adults and patients with HIV may need modification of highly intensive therapy. [24]"
          ],
          [
            "High-risk DA-EPOCH-R after two cycles",
            "PET response. [24]",
            "Continue protocol-directed treatment with CNS therapy determined by baseline CSF status. [24]"
          ],
          [
            "After completion",
            "Clinical evidence of relapse, particularly during the first year. [23]",
            "Investigate new symptoms promptly; in endemic disease, relapse risk is reported as 5% or less after one event-free year. [23]"
          ]
        ]
      }
    }
  ],
  "faq": [],
  "references": [
    {
      "number": 1,
      "title": "Diagnosis and treatment of Burkitt lymphoma in adults",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(24)00351-X/abstract",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com"
    },
    {
      "number": 2,
      "title": "Supplementary appendix",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/cms/10.1016/S2352-3026(23)00279-X/attachment/9fcc9dc8-c05b-49d8-af41-24e129521867/mmc1.pdf",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com"
    },
    {
      "number": 3,
      "title": "Cancer in sub-Saharan Africa",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00720-8/fulltext?k=safety+eyes+for+stuffed+animals",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com"
    },
    {
      "number": 4,
      "title": "Haematological malignancies in sub-Saharan Africa",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(21)00198-8/abstract",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com"
    },
    {
      "number": 5,
      "title": "Self-Enforcing Feedback Activation between BCL6 and Pre ...",
      "detail": "www.cell.com",
      "url": "https://www.cell.com/cms/10.1016/j.ccell.2015.02.003/attachment/47d51fc3-c3c7-4656-b3dd-5d04dd84f564/mmc2.pdf",
      "authors": "www.cell.com",
      "host": "www.cell.com"
    },
    {
      "number": 6,
      "title": "ORAL PAPER ABSTRACTS : Indian Journal of Pathology ...",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/ijpm/fulltext/2022/65002/oral_paper_abstracts.11.aspx",
      "authors": "journals.lww.com",
      "host": "journals.lww.com"
    },
    {
      "number": 7,
      "title": "Abstracts : Indian Journal of Nuclear Medicine",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/ijnm/fulltext/2023/38001/abstracts.4.aspx",
      "authors": "journals.lww.com",
      "host": "journals.lww.com"
    },
    {
      "number": 8,
      "title": "Chinese expert consensus on clinical practice of female ...",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/rdm/_layouts/15/oaks.journals/downloadpdf.aspx?an=02114886-202203000-00008",
      "authors": "journals.lww.com",
      "host": "journals.lww.com"
    },
    {
      "number": 9,
      "title": "molecular approaches in pediatric hematologic malignancies",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/annals-of-medicine-and-surgery/_layouts/15/oaks.journals/downloadpdf.aspx?an=01845215-202510000-00040",
      "authors": "journals.lww.com",
      "host": "journals.lww.com"
    },
    {
      "number": 10,
      "title": "Dose‐intensive chemotherapy including rituximab in Burkitt's ...",
      "detail": "acsjournals.onlinelibrary.wiley.com",
      "url": "https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.27918",
      "authors": "acsjournals.onlinelibrary.wiley.com",
      "host": "acsjournals.onlinelibrary.wiley.com"
    },
    {
      "number": 11,
      "title": "British HIV Association guidelines for ...",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/10.1111/hiv.12136",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com"
    },
    {
      "number": 12,
      "title": "Lymphoma - Tsang - Major Reference Works",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/full/10.1002/9780471420194.tnmm32",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com"
    },
    {
      "number": 13,
      "title": "safety and efficacy results of the “CARMEN” phase II trial",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/10.1111/bjh.17188",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com"
    },
    {
      "number": 14,
      "title": "Targeted therapy in Burkitt lymphoma: Small molecule ...",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/10.1111/bjh.19425",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com"
    },
    {
      "number": 15,
      "title": "HIV-associated Burkitt lymphoma - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S2352302620301265",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    },
    {
      "number": 16,
      "title": "Influence of Rituximab on Central Nervous System Relapse in Diffuse Large B-Cell Lymphoma and Role of Prophylaxis—A Systematic Review of Prospective Studies - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S2152265015000701",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    },
    {
      "number": 17,
      "title": "(PDF) BURKITT LYMPHOMA MIMICKING SEPTIC SHOCK",
      "detail": "journal.chestnet.org",
      "url": "https://journal.chestnet.org/article/S0012-3692(21)02151-6/pdf",
      "authors": "journal.chestnet.org",
      "host": "journal.chestnet.org"
    },
    {
      "number": 18,
      "title": "MYC rearrangements in high-grade B-cell lymphoma with ...",
      "detail": "ashpublications.org",
      "url": "https://ashpublications.org/blood/article/144/5/525/516008/Motive-and-opportunity-MYC-rearrangements-in-high",
      "authors": "ashpublications.org",
      "host": "ashpublications.org"
    },
    {
      "number": 19,
      "title": "T(8;22)(q24;q11) In a Context of Complex Karyotype In Two ...",
      "detail": "ashpublications.org",
      "url": "https://ashpublications.org/blood/article/116/21/5093/66454/T-8-22-q24-q11-In-a-Context-of-Complex-Karyotype",
      "authors": "ashpublications.org",
      "host": "ashpublications.org"
    },
    {
      "number": 20,
      "title": "High-grade B-cell lymphoma, not otherwise specified",
      "detail": "ashpublications.org",
      "url": "https://ashpublications.org/bloodadvances/article/7/21/6381/495790/High-grade-B-cell-lymphoma-not-otherwise-specified",
      "authors": "ashpublications.org",
      "host": "ashpublications.org"
    },
    {
      "number": 21,
      "title": "Diagnosis of 'double hit' diffuse large B-cell lymphoma and B ...",
      "detail": "ashpublications.org",
      "url": "https://ashpublications.org/hematology/article-abstract/2014/1/90/20557",
      "authors": "ashpublications.org",
      "host": "ashpublications.org"
    },
    {
      "number": 22,
      "title": "Multicenter Study of Risk-Adapted Therapy With Dose-Adjusted EPOCH-R in Adults With Untreated Burkitt Lymphoma | Journal of Clinical Oncology",
      "detail": "ascopubs.org",
      "url": "https://ascopubs.org/doi/abs/10.1200/JCO.20.00303?journalCode=jco",
      "authors": "ascopubs.org",
      "host": "ascopubs.org"
    },
    {
      "number": 23,
      "title": "Burkitt Lymphoma - StatPearls - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/portal/utils/pageresolver.fcgi?recordid=698fda7350bd6f6bff1a167c",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov"
    },
    {
      "number": 24,
      "title": "Multicenter Study of Risk-Adapted Therapy With Dose-Adjusted EPOCH-R in Adults With Untreated Burkitt Lymphoma - PMC",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392744",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov"
    }
  ],
  "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.",
  "citations": [
    {
      "number": 1,
      "title": "Diagnosis and treatment of Burkitt lymphoma in adults",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(24)00351-X/abstract",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com",
      "snippet": "by V Ribrag · 2025 · Cited by 21 — Burkitt lymphoma is a rare lymphoma entity that represents less than 5% of adult lymphomas. Review contains specific recommendations for the identification and",
      "score": 0.43741554
    },
    {
      "number": 2,
      "title": "Supplementary appendix",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/cms/10.1016/S2352-3026(23)00279-X/attachment/9fcc9dc8-c05b-49d8-af41-24e129521867/mmc1.pdf",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com",
      "snippet": "Rationale. Standard treatment of Burkitt lymphoma with high dose multi-agent chemotherapy (R-CODOX-M/R-IVAC) is effective (2 year Progression",
      "score": 0.23480159
    },
    {
      "number": 3,
      "title": "Cancer in sub-Saharan Africa",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00720-8/fulltext?k=safety+eyes+for+stuffed+animals",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com",
      "snippet": "by W Ngwa · 2022 · Cited by 484 — Burkitt lymphoma, Burkitt lymphoma treatment regimens developed and tested in SSA still cure more than 50% of children.182 Wilms tumour Scopus",
      "score": 0.19525662
    },
    {
      "number": 4,
      "title": "Haematological malignancies in sub-Saharan Africa",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(21)00198-8/abstract",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com",
      "snippet": "by CD Okello · 2021 · Cited by 35 — Haematological malignancies account for almost 10% of all cancers diagnosed in sub-Saharan Africa, Burkitt's tumor lymphoblasts. Burkitt",
      "score": 0.12407521
    },
    {
      "number": 5,
      "title": "Self-Enforcing Feedback Activation between BCL6 and Pre ...",
      "detail": "www.cell.com",
      "url": "https://www.cell.com/cms/10.1016/j.ccell.2015.02.003/attachment/47d51fc3-c3c7-4656-b3dd-5d04dd84f564/mmc2.pdf",
      "authors": "www.cell.com",
      "host": "www.cell.com",
      "snippet": "For the BCL6 studies, a Burkitt lymphoma bone marrow sample acted as a positive control and a chronic myeloid leukemia sample acted as a",
      "score": 0.20875941
    },
    {
      "number": 6,
      "title": "ORAL PAPER ABSTRACTS : Indian Journal of Pathology ...",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/ijpm/fulltext/2022/65002/oral_paper_abstracts.11.aspx",
      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "Burkitt lymphoma (BL) is a high grade B-cell non-Hodgkin lymphoma (NHL) occurring in children and adults. use Large B-cell Lymphoma is the commonest type of",
      "score": 0.3753864
    },
    {
      "number": 7,
      "title": "Abstracts : Indian Journal of Nuclear Medicine",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/ijnm/fulltext/2023/38001/abstracts.4.aspx",
      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "Introduction: Burkitt lymphoma (BL) is a highly aggressive B cell non-Hodgkin lymphoma. Average age of diagnosis in paediatric patients is 3 to 12 years. It is often associated with Epstein-Barr virus(EBV) infection. WHO has categorized it into 3 clinical variants- endemic BL, sporadic BL and immuno",
      "score": 0.32165226
    },
    {
      "number": 8,
      "title": "Chinese expert consensus on clinical practice of female ...",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/rdm/_layouts/15/oaks.journals/downloadpdf.aspx?an=02114886-202203000-00008",
      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "by W Li · 2022 · Cited by 3 — Burkitt's lymphoma have a higher risk of ovarian metastasis, recommended in patients with high-grade non- and Burkitt's lymphomas,",
      "score": 0.26392224
    },
    {
      "number": 9,
      "title": "molecular approaches in pediatric hematologic malignancies",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/annals-of-medicine-and-surgery/_layouts/15/oaks.journals/downloadpdf.aspx?an=01845215-202510000-00040",
      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "by EI Obeagu · 2025 · Cited by 6 — Burkitt lymphoma and diffuse large B-cell lymphoma, frequently involve rearrange- ments of the MYC, BCL2, and BCL6 genes.",
      "score": 0.17229746
    },
    {
      "number": 10,
      "title": "Dose‐intensive chemotherapy including rituximab in Burkitt's ...",
      "detail": "acsjournals.onlinelibrary.wiley.com",
      "url": "https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.27918",
      "authors": "acsjournals.onlinelibrary.wiley.com",
      "host": "acsjournals.onlinelibrary.wiley.com",
      "snippet": "Jan 29, 2013 — Excellent immunological recovery following CODOX-M/IVAC, an effective intensive chemotherapy for HIV-associated Burkitt's lymphoma. AIDS.",
      "score": 0.6688159
    },
    {
      "number": 11,
      "title": "British HIV Association guidelines for ...",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/10.1111/hiv.12136",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "Excellent immunological recovery following CODOX-M/IVAC, an effective intensive chemotherapy for HIV-associated Burkitt's lymphoma.",
      "score": 0.56431514
    },
    {
      "number": 12,
      "title": "Lymphoma - Tsang - Major Reference Works",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/full/10.1002/9780471420194.tnmm32",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "CNS prophylaxis is required; A typical regimen is CODOX-M-IVAC as proposed by Magrath, consisting of fractionated doses of cyclophosphamide",
      "score": 0.532839
    },
    {
      "number": 13,
      "title": "safety and efficacy results of the “CARMEN” phase II trial",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/10.1111/bjh.17188",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "Oct 21, 2020 — Excellent immunological recovery following CODOX-M/IVAC, an effective intensive chemotherapy for HIV-associated burkitt's lymphoma. AIDS ...Read more",
      "score": 0.4574039
    },
    {
      "number": 14,
      "title": "Targeted therapy in Burkitt lymphoma: Small molecule ...",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/10.1111/bjh.19425",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "Multiagent chemoimmunotherapy remains the standard of care treatment for Burkitt lymphoma leading to a cure in the majority of cases.",
      "score": 0.4338141
    },
    {
      "number": 15,
      "title": "HIV-associated Burkitt lymphoma - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S2352302620301265",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: HIV-associated Burkitt lymphoma - ScienceDirect\n# HIV-associated Burkitt lymphoma. In this Review of HIV-associated Burkitt lymphoma, we summarise expert opinion and provide general recommendations for the treatment of Burkitt lymphoma in patients with HIV on the basis of retrospective and pr",
      "score": 0.75616
    },
    {
      "number": 16,
      "title": "Influence of Rituximab on Central Nervous System Relapse in Diffuse Large B-Cell Lymphoma and Role of Prophylaxis—A Systematic Review of Prospective Studies - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S2152265015000701",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: Influence of Rituximab on Central Nervous System Relapse in Diffuse Large B-Cell Lymphoma and Role of Prophylaxis—A Systematic Review of Prospective Studies - ScienceDirect\n## Article preview. ## Clinical Lymphoma Myeloma and Leukemia. Clinical Lymphoma Myeloma and Leukemia. # Influence of Ri",
      "score": 0.5068117
    },
    {
      "number": 17,
      "title": "(PDF) BURKITT LYMPHOMA MIMICKING SEPTIC SHOCK",
      "detail": "journal.chestnet.org",
      "url": "https://journal.chestnet.org/article/S0012-3692(21)02151-6/pdf",
      "authors": "journal.chestnet.org",
      "host": "journal.chestnet.org",
      "snippet": "BL is a rare, it is highly curable with a two-year survival rate of 80-90%, treatment consisting of multi-agent regimens.",
      "score": 0.21428047
    },
    {
      "number": 18,
      "title": "MYC rearrangements in high-grade B-cell lymphoma with ...",
      "detail": "ashpublications.org",
      "url": "https://ashpublications.org/blood/article/144/5/525/516008/Motive-and-opportunity-MYC-rearrangements-in-high",
      "authors": "ashpublications.org",
      "host": "ashpublications.org",
      "snippet": "MYC rearrangements (MYC-Rs) are universal in Burkitt lymphoma (BL)1,2; BCL2 rearrangements (BCL2-Rs) occur in ∼85% of follicular lymphomas (FLs)",
      "score": 0.5065188
    },
    {
      "number": 19,
      "title": "T(8;22)(q24;q11) In a Context of Complex Karyotype In Two ...",
      "detail": "ashpublications.org",
      "url": "https://ashpublications.org/blood/article/116/21/5093/66454/T-8-22-q24-q11-In-a-Context-of-Complex-Karyotype",
      "authors": "ashpublications.org",
      "host": "ashpublications.org",
      "snippet": "Burkitt lymphoma (LB) and Diffuse Large Cell Lymphoma B (DLCL-B) with MYC gene rearrangement. The MYC gene is often rearranged with the gene",
      "score": 0.5003668
    },
    {
      "number": 20,
      "title": "High-grade B-cell lymphoma, not otherwise specified",
      "detail": "ashpublications.org",
      "url": "https://ashpublications.org/bloodadvances/article/7/21/6381/495790/High-grade-B-cell-lymphoma-not-otherwise-specified",
      "authors": "ashpublications.org",
      "host": "ashpublications.org",
      "snippet": "Burkitt lymphoma was considered in the differential diagnosis of Burkitt-like HGBL, NOS, and ruled out based on ≥1 exclusionary criteria:",
      "score": 0.46453777
    },
    {
      "number": 21,
      "title": "Diagnosis of 'double hit' diffuse large B-cell lymphoma and B ...",
      "detail": "ashpublications.org",
      "url": "https://ashpublications.org/hematology/article-abstract/2014/1/90/20557",
      "authors": "ashpublications.org",
      "host": "ashpublications.org",
      "snippet": "by SH Swerdlow · 2014 · Cited by 213 — MYC rearrangements are aggressive neoplasms with clinical and pathologic features distinct from Burkitt lymphoma and diffuse large B-cell",
      "score": 0.464392
    },
    {
      "number": 22,
      "title": "Multicenter Study of Risk-Adapted Therapy With Dose-Adjusted EPOCH-R in Adults With Untreated Burkitt Lymphoma | Journal of Clinical Oncology",
      "detail": "ascopubs.org",
      "url": "https://ascopubs.org/doi/abs/10.1200/JCO.20.00303?journalCode=jco",
      "authors": "ascopubs.org",
      "host": "ascopubs.org",
      "snippet": "We tested infusional chemotherapy for prolonged exposure time without high peak drug concentrations in a pilot study of dose-adjusted infusional etoposide, doxorubicin, and vincristine with prednisone, cyclophosphamide, and rituximab (EPOCH-R) and showed high efficacy in adult Burkitt lymphoma.19 We",
      "score": 0.73981786
    },
    {
      "number": 23,
      "title": "Burkitt Lymphoma - StatPearls - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/portal/utils/pageresolver.fcgi?recordid=698fda7350bd6f6bff1a167c",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "Title: Burkitt Lymphoma - StatPearls - NCBI Bookshelf\nBurkitt lymphoma is an aggressive non-Hodgkin B-cell lymphoma characterized by rapid tumor growth, frequently affecting the jaw, abdomen, or central nervous system associated with Epstein-Barr virus (EBV), human immunodeficiency virus (HIV), and ",
      "score": 0.71305263
    },
    {
      "number": 24,
      "title": "Multicenter Study of Risk-Adapted Therapy With Dose-Adjusted EPOCH-R in Adults With Untreated Burkitt Lymphoma - PMC",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392744",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "Title: Multicenter Study of Risk-Adapted Therapy With Dose-Adjusted EPOCH-R in Adults With Untreated Burkitt Lymphoma - PMC\nWe tested infusional chemotherapy for prolonged exposure time without high peak drug concentrations in a pilot study of dose-adjusted infusional etoposide, doxorubicin, and vin",
      "score": 0.6894943
    }
  ],
  "publishedAt": "2026-08-21T02:11:54.245758+00:00",
  "updatedAt": "2026-08-21T02:11:54.245758+00:00",
  "readingMinutes": 6,
  "slug": "burkitt-lymphoma"
}