Community Resources

Burkitt's lymphoma (BL) is an aggressive monoclonal B-cell , non-Hodgkin lymphoma that occurs as three clinical variants, endemic, sporadic, and immunodeficiency-associated. Endemic Burkitt’s lymphoma occurs in countries in equatorial Africa and Papua New Guinea, where it is 15-100 times more common than in developed countries and the most common malignancy among children.

Endemic Burkitt’s lymphoma is a rapidly growing tumor with changes being notable from day to day. In the 1960’s and 1970’s, Burkitt’s lymphoma was described as typically involving jaws and orbital bones. Recent reports suggest that involvement of abdominal organs, including kidneys, ovaries, and liver, has become more common. Involvement at these anatomic sites requires use of ultrasound for more complete diagnosis. Lymph nodes and bone marrow are distinctly rare, but the lack of systematic studies makes it impossible to determine their prevalence. The central nervous system can also be involved.

Burkitt’s lymphoma in Africa is often diagnosed clinically, but biopsy or fine needle aspiration for cytology is required for a definitive diagnosis. Historically, diagnosis was based on morphological pattern of tumor cells, but recent methods include use of immunohistochemistry to measure B cell surface and cytoplasmic markers (e.g., CD20, BCl-6) and cytogenetic markers for translocation. A rapid diagnosis is essential since the tumor cells double every day. The tumor stage should be determined by clinical examination and laboratory and imaging tests. The outcome of treatment depends on the stage of the disease.

Burkitt’s lymphoma in Africa can be cured in about 50% of patients using relatively inexpensive chemotherapy discovered more than 40 years ago. The main barriers to successful treatment include delay in diagnosis, referral, and abandonment of treatment by patients. Patients who are started on treatment need to be followed at regular intervals to identify relapse or document cure.