The disease is associated with Epstein-Barr virus and was one of the first tumours shown to have a chromosomal translocation that activates an oncogene (c-MYC). Burkitt's lymphoma is the most common childhood cancer in areas where malaria is holoendemic.
The incidence is very high in immunosuppressed patients in non-endemic areas, especially when associated with HIV infection.
Outcome with intensive chemotherapy has improved and is now excellent in children, but the prognosis is poor in elderly adults.
The success of intensive treatment relies on good supportive care.
The therapy offered in oncology units in low-income countries is not as aggressive as in centres in high-income countries and outcomes are less successful.
Adjuvant monoclonal antibody therapy with rituximab shows promise for improved outcomes and reduced toxic effects in the future.
College Of Medicine, Blantyre, Malawi. emolyneux [at] malawi.net
Lancet. 2012 Mar;379(9822):1234-44
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