Burkitt's and Burkitt‐like lymphoma in children and adolescents: a review of the Children's Cancer Group Experience*

Abstract

Summary. Historically, the survival of children and adolescents with Burkitt's and Burkitt-like lymphoma had been poor. Recently, short and intensive chemotherapy appears to have improved disease outcome. We therefore reviewed the results of four successive Children's Cancer Group trials conducted on 470 children with disseminated Burkitt's and Burkitt-like lymphoma. Of the patients studied, the median age was 8 years (0-21 years), the male:female ratio was 4:1, 58% had lactate dehydrogenase (LDH) ‡ 500 IU/l, 23% had M2 or M3 bone marrow (BM), and 12% demonstrated central nervous system involvement. In a multivariate analysis, the 4-year event-free survival (EFS) in patients ‡ 15-years-old compared with < 15-year-old was 34 ± 7 versus 59 ± 2% (P < 0AE05), the 4-year EFS of M2/M3 compared with M1 BM was 38 ± 5 versus 63 ± 3% (P < 0AE001), and the 4-year EFS with LDH ‡ 500 IU/l compared with LDH < 500 IU/l was 49 ± 3 versus 71 ± 4% (P < 0AE001). Furthermore, patients treated on the most recent protocol, which was short and more intensive, had a significantly improved survival compared with those on previous trials (4-year EFS 80 ± 6 versus 54 ± 2%, P < 0AE001). In summary, the outcome for childhood Burkitt's and Burkitt-like lymphoma has recently improved with the use of short and intensive B-cell non-Hodgkin's lymphoma-directed therapy.

Translocations involving 8q24 in Burkitt lymphoma and other malignant lymphomas: a historical review of cytogenetics in the light of todays knowledge

“…This supports recent studies, 25,26,39 suggesting that from a cytogenetic and gene expression point of view, BL in children and adults is the same disease. The differences between children and adults found by others in smaller cohorts 36,40,41 may represent the inclusion of BL mimickers. In light of these results and also the fact that the genetic profile of the patients with no data on age available were almost identical, we extended our core subset to BL IG-MYC single hit samples independent of patient age (Figure 3).…”

Results of a randomized international study of high-risk central nervous system B non-Hodgkin lymphoma and B acute lymphoblastic leukemia in children and adolescents

“…[1][2][3][4][5][6][7][8] About 90% of histologic subtypes of childhood de novo high-risk (BM with or without CNS) B-NHL are of the aggressive subtype, including mature B-cell acute lymphoblastic leukemia (B-ALL), Burkitt lymphoma (BL) and Burkitt-like (BLL) histology and to a lesser extent, an intermediate subtype, diffuse large B-cell lymphoma (DLBCL). [9][10][11] Despite an improvement in overall survival (S) with multiagent intensive chemotherapy, there is a significant incidence of serious morbidity, including grade III/IV mucositis (40%-70%), systemic infection (60%-80%), myelosuppression (80%-100%), prolonged hospitalization (median 10-14 days during each induction cycle), and a toxic death rate of 1%-2% in remission with potential long-term cardiac and gonadal toxicities and secondary malignancies.…”

Clinicopathologic and Survival Characteristics of Childhood and Adolescent Non Hodgkin's Lymphoma in Yazd, Iran

“…The current study and similar reports from some of the surrounding Middle East countries as well as the West show a low relative proportion of T-cell lymphomas (Naresh et al, 2004;Economopoulos et al, 2005). It was claimed that non Hodgkin lymphoma, occurring in adolescence was an independent risk factor for a poorer prognosis compared with that occurring in children younger than 15 years of age (Cairo et al, 2003). However it was not true in the presented study and overall survival in the age group over 15 years was longer than the age group younger than 15 years of age, but this difference failed to reach statistical significance (p value=0.17).…”