Overview of Burkitt’s lymphoma, the most affected patient populations
Pharmacy hours interviewed Adam Olszewski, MD, associate professor of medicine at Alpert School of Medicine at Brown University, to discuss his presentation at the SOHO 2021 conference on the prognosis and treatment of Burkitt’s lymphoma in the modern era.
Alana Hippensteele: What is Burkitt’s lymphoma and is there a patient population that is particularly affected by the disease?
Adam Olszewski: Thank you for. Burkitt’s lymphoma is a very interesting disease. It is a rare subtype of non-Hodgkin lymphoma which, in adults, may only represent 1% of all cases of non-Hodgkin lymphoma; it is probably more common in the pediatric population. I am an adult hematologist, so I mainly treat adults.
It is considered to be the fastest growing human cancer and the main feature of these diseases is probably that it is made up of very rapidly dividing cells, essentially 100% of which undergo division at any time. It is known to double in size, sometimes in 24 hours.
It is not universal; there are some cases that develop oddly more slowly, but it is a challenge for oncologists due to the rapidity of its growth, with rapid spread to ganglionic and extranodal organs and the intensity of treatment required to cure it.
Another peculiarity of Burkitt’s lymphoma is that it is considered to be a highly curable disease. As long as the treatment is carried out expertly and promptly, the general belief is that patients should be cured.
It interestingly affects younger patients compared to possibly other aggressive B-cell lymphomas, such as diffuse large B-cell or high-grade B-cell lymphoma, in which the median age is in the 40s. , there are a lot of pediatric patients. We also know that there are 3 subcategories or variants of Burkitt’s lymphoma that are somewhat related to the risk factors of it, so it has been called endemic Burkitt lymphoma, which is associated with the infection with Epstein-Barr virus, and this variant predominates in the equatorial band in Africa, Papua New Guinea and other geographically regions.
Then there is the variant associated with immunodeficiency, which in Western countries is mainly seen in patients with HIV infection, so it is a major risk factor, and probably, at this stage, it is the one of the most common lymphomas diagnosed in patients with HIV infection. It is typically diagnosed in patients with fairly good control of their infection, with a good number of CD4 cells, a viral load which is sometimes undetectable.
Second, the vast majority of patients in the United States are patients with sporadic Burkitt lymphoma, which happens randomly.