Burkitt’s 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's lymphoma (BL) is a highly aggressive lymphoma and is characterized by an extraordinarily high cell division rate of B cells.

Burkitt's lymphoma - Classification

According to the WHO, 3 clinical variants of Burkitt’s lymphoma (BL) are recognized: the endemic Burkitt's lymphoma is occurs in tropical regions, e.g. in Africa, and is associated with a tumour-inducing effect of EBV. There it is one of the most frequent tumor diseases in children between the ages of 4-7 years. The sporadic Burkitt's lymphoma occurs in temperate climate zones (mainly USA and Western Europe), accounting for 1-2% of all lymphomas. The median age of the adults is 30 years, with men being affected twice as often as women. Immunodeficiency-associated Burkitt's lymphoma is more common in the setting of HIV Infection than in other forms of immunosuppression. A leukemic form of Burkitt's lymphoma is characterized by a bone marrow infiltration of more than 25% lymphocytic blasts in the bone marrow and is called Burkitt's leukemia (formerly "mature B-ALL").

A new provisional entity described in the WHO 2017 includes "Burkitt-like" lymphoma with 11q aberration. Burkitt-like lymphoma with 11q aberration is similar to Burkitt's lymphoma in morphology and gene expression profile, but differs from it cytogenetically, clinically (often nodal involvement) and molecularly.

Diagnostics of Burkitt's lymphoma

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

Prognosis of Burkitt's lymphoma

Since Burkitt's lymphoma is an aggressively growing tumor with a proliferation rate of often 100%, early therapy is necessary. Intensive combination chemotherapy leads to a 5-year survival of 90% for adolescents, 84% for adults and 62% for elderly patients (Hölzer et al. 2014).

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