Burkitt lymphoma (BL)

  • Method:
  • Anticoagulant:
  • Recommendation:
  • Method:
    Cytomorphology
  • Anticoagulant:
    EDTA
  • Recommendation:
    obligatory
  • Method:
    Immunophenotyping
  • Anticoagulant:
    EDTA or Heparin
  • Recommendation:
    obligatory
  • Method:
    Chromosome analysis
  • Anticoagulant:
    Heparin
  • Recommendation:
    facultative
  • Method:
    FISH
  • Anticoagulant:
    EDTA or Heparin
  • Recommendation:
    obligatory*
  • Method:
    Molecular genetics
  • Anticoagulant:
    EDTA or Heparin
  • Recommendation:
    facultative

*As test material for the FISH analysis we recommend unfixed, unstained smears

Burkitt lymphoma (BL) is one of the aggressive lymphomas and is characterized by an extraordinarily high cell division rate of B cells. Based on current guidelines and the current state of research, there are various diagnostic recommendations for patients with Burkitt lymphoma. We have summarized the most important information on the classification and diagnostic methods at MLL. In addition, we have compiled further literature on prognosis and therapy in Burkitt lymphoma, so that you can inform yourself in more detail.

Burkitt lymphoma: Classification

According to WHO, 3 clinical variants are distinguished (Fig. 1). A leukemic course of Burkitt lymphoma is characterized by a bone marrow infiltration of more than 25% of lymphoid blasts in the bone marrow and is called Burkitt leukemia (formerly "mature B-ALL").

Figure 1: Variants of Burkitt lymphoma (Swerdlow et al. 2017)


A new provisional entity described in WHO 2017 includes "Burkitt-like" lymphoma with 11q alterations. Burkitt-like lymphoma with 11q alteration is similar to Burkitt lymphoma in morphology and gene expression profile, but differs from it cytogenetically, clinically (frequent nodal involvement), and molecularly (Swerdlow et al. 2017, Gonzalez-Farre et al. 2019, Wagener et al. 2019).

Burkitt lymphoma: Diagnostic methods and their relevance

Since there is no method that represents the sole gold standard in the diagnosis of Burkitt lymphoma or Burkitt leukemia, an integrated diagnostic approach taking into account morphology/histology, immunophenotype, and genetics is central. Due to the frequent CNS involvement, especially in the setting of Burkitt leukemia, an additional cerebrospinal fluid (CSF) examination should be performed.

Burkitt lymphoma: Prognosis and therapy

Because Burkitt lymphoma is an aggressively growing tumor with a proliferation rate of up to 100% (Swerdlow et al. 2017), rapid and consistent therapy is required. Intensive combination chemotherapy results in 5-year survival of 90% for adolescents, 84% for adults, and 62% for elderly patients (Hoelzer et al. 2014).

Risk assessment of patients with Burkitt lymphoma can be assisted by the BL-IPI (BL International Prognostic Index), which analyzes various clinical parameters (Olszewski et al. 2021) that also have prognostic significance in HIV-associated BL (Alderuccio et al. 2021).

Therapeutic options can be found in a recent review by Crombie and LaCasce, among others (Crombie & LaCasce 2021).

Status: June 2022

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