Burkitt Lymphoma in Children
Burkitt lymphoma is a rare, fast-growing form of non-Hodgkin lymphoma (NHL). It’s
type of cancer that starts in white blood cells in the lymphatic system. It's named
the doctor who first described it in children in Africa.
The lymphatic system is part of the
immune system. It helps the body fight diseases and infections. The lymphatic system
also helps balance fluids in different parts of the body. The lymphatic system
Lymph. This is a clear fluid that contains
white blood cells called lymphocytes.
Lymph vessels. These are tiny tubes that carry
lymph fluid all over the body.
Lymphocytes. These are white blood cells
that fight infections and disease. Burkitt lymphoma starts in the type of lymphocyte
Lymph nodes. These are small bean-shaped
organs. They're scattered all over the body. They're connected by lymph vessels. And
they filter the lymph fluid as it moves around the body.
Other organs and body tissues. The
lymphatic system includes the bone marrow where blood is made. It also includes the
spleen, thymus, and tonsils.
There are 3 main types of Burkitt lymphoma in children:
Endemic (African). Endemic means it is
common in 1 area. This type is a common childhood cancer in central Africa and New
Guinea. It causes large tumors of the face and jaw. It's rare in the U.S.
Sporadic (nonendemic). This is the type
most often seen in the U.S. and Western Europe. It often causes large tumors in the
Immunodeficiency-associated. This type
mostly affects children who have a weak immune system due to HIV infection, an
inherited disease, or because they take medicines after organ transplant. It also
causes tumors on the abdomen.
In children, Burkitt lymphoma is most
common in boys between ages 5 and 10.
other types of NHL, the exact cause of Burkitt lymphoma isn't known. Some viral
infections may increase a child’s risk of having Burkitt lymphoma. The viruses that
linked to Burkitt lymphoma include:
- Epstein-Barr virus (EBV), the virus that causes mono (mononucleosis)
- HIV, the
virus that causes AIDS
The symptoms of Burkitt lymphoma often start suddenly, and the tumors tend to grow
quickly. A child can become very sick in a few days to a few weeks.
Symptoms of a belly (abdominal)
tumor can include:
- Abdominal pain and swelling
with bowel movements (constipation)
- Poor appetite
full quickly, such as after eating a small amount of food
symptoms may include:
swelling of the lymph nodes in the neck, chest, abdomen, underarm, or groin
- Coughing or trouble breathing
symptoms of Burkitt lymphoma can look like other health conditions. Make sure your
sees a healthcare provider for a diagnosis.
child's healthcare provider will ask about your child's health history and symptoms.
They will examine your child. Your child may need tests such as:
Blood and urine tests. Blood and urine
samples are tested in a lab.
Tissue biopsy. A small piece of tissue
(called a sample) is taken from the tumor, lymph nodes, or other tissue. It’s sent
a lab and tested for cancer cells.
Chest X-ray. This shows the heart, lungs, and other
parts of the chest.
CT scan. This may be done to look at the abdomen, chest, and pelvis. A CT scan uses a
series of X-rays and a computer to make detailed 3-D pictures of the inside of the
body. Your child may drink a contrast dye. Or a dye may be injected into a vein. The
dye helps show more details.
MRI scan. An MRI uses large magnets, radio
waves, and a computer to make detailed pictures of the inside of the body. This test
might be used to check the brain and spinal cord. Or it may be used if the results
an X-ray or CT scan are unclear.
PET scan. This scan is used to
look for active tumor cells all over the body.
Ultrasound. This is also called sonography. Sound waves and a computer are used to make
pictures of blood vessels, tissues, and organs.
Bone marrow aspiration or biopsy. Bone
marrow is the thick liquid in the center of some bones. It’s where blood cells are
made. A small amount of bone marrow fluid may be taken out. This is called
aspiration. Or solid pieces of bone marrow tissue may be taken. This is called a core
biopsy. Bone marrow is often taken from the back of the hip bone. This test may be
done to see if cancer cells have spread to the bone marrow.
Lumbar puncture (spinal tap). A thin needle
is put between the bones in the lower back and into the spinal canal. This is the
area around the spinal cord. This is done to see if there are cancer cells in
the brain and spinal cord. A small amount of cerebrospinal fluid (CSF) is taken out
and sent for testing. CSF is the fluid around the brain and spinal cord.
of diagnosing cancer is called staging. Staging is the process of seeing if the cancer
has spread, and where it has spread. Staging also helps to decide on the best treatment.
There are different ways of staging NHL. But most range from stage 1 to stage 4. Stage
is cancer that has spread to parts of the body that are not part of the lymphatic
system. Talk with your child's healthcare provider about the stage of your child's
cancer and what it means.
Treatment will depend on the type and stage. Burkitt lymphoma is most often treated
Chemotherapy (chemo). These are strong
medicines that kill cancer cells or stop them from growing. Chemo is the main
treatment for Burkitt lymphoma. Often more than 1 type of chemo is used. If cancer
cells are found in the CSF, chemo will need to be given there, too.
Immunotherapy. These are
medicines that boost the immune system to better find and kill cancer cells. They're
often given along with chemo.
Surgery. If there's only 1 large tumor,
surgery may be done to remove it. This is done before chemotherapy.
Clinical trials. Most children with cancer
are treated as part of a clinical trial. Taking part in a clinical trial means your
child gets the best treatment available today, and might also get new treatments that
are thought to be even better. Before starting treatment, talk to your child's
healthcare provider to find out if there are any treatments being tested that may
work well for your child. Many new treatments are only available in clinical trials.
lymphoma grows quickly and the tumors are often very big. When chemo starts, it kills
lot of cancer cells in a short time. This cell waste can build up in your child's
and cause a problem called tumor lysis syndrome (TLS). TLS can cause kidney damage
problems with the heart and nervous system. Your child will be given medicines and
of IV fluids to help keep this from happening.
child will need follow-up care during and after treatment to:
on your child's response to the treatment
the side effects of treatment
- See if
the cancer has come back or spread
treatment, most children with Burkitt lymphoma go on to live long lives. With any
cancer, how well a child is expected to recover (their prognosis) varies. Keep in
medical treatment right away is important for the best prognosis.
follow-up care during and after treatment is needed.
treatments are being tested to improve outcome and lessen side effects.
with the doctor about any concerns you may have or problems you may notice. Your
child's treatment team wants to know as much as they can about how your child is
Possible complications depend on the type and stage of the lymphoma, as well as the
treatment used. Your child may have short- and long-term problems from the tumor or
treatment. These may include things like:
- Increased risk for infection
- Increased risk for bleeding
- Sores in
- Increased risk for having other cancers later in life
having children (infertility)
side effects can be treated to keep them from getting worse. There may even be things
you can do to help prevent some of them. Talk with the doctor about what you should
watch for and what can be done to help prevent complications.
can help your child manage their treatment in many ways. For example:
child may have trouble eating. A dietitian may be able to help.
child may be very tired. They will need to balance rest and activity. Encourage your
child to get some exercise. This is good for overall health. And it may help to
emotional support for your child. Find a counselor or child support group that can
sure your child goes to all follow-up appointments.
When to Call a Healthcare Provider
the healthcare provider if your child has:
- Symptoms that get worse
effects from treatment that affect your child's daily function or don't get better
Ask your child's healthcare provider what signs to watch for and when
to call. Know how to get help after office hours and on weekends and holidays.
lymphoma is a very fast-growing type of non-Hodgkin lymphoma.
often causes large belly (abdominal) tumors.
- A child
may have swollen lymph nodes, tiredness, fever, and other symptoms.
treated with chemotherapy and surgery.
treatment, most children with Burkitt lymphoma go on to live long lives.
care after treatment is important.
to help you get the most from a visit to your child’s healthcare provider:
the reason for the visit and what you want to happen.
your visit, write down questions you want answered.
- At the
visit, write down the name of a new diagnosis, and any new medicines, treatments,
tests. Also write down any new instructions your provider gives you for your
- Know why
a new medicine or treatment is prescribed and how it will help your child. Also know
what the side effects are.
- Ask if
your child’s condition can be treated in other ways.
- Know why
a test or procedure is recommended and what the results could mean.
what to expect if your child does not take the medicine or have the test or
- If your
child has a follow-up appointment, write down the date, time, and purpose for that
how you can contact your child’s provider after office hours. This is important if
your child becomes ill and you have questions or need advice.