Burkitt lymphoma

It is a fast-growing non-Hodgkin lymphoma arising from B cells — the white blood cells that normally make antibodies.

It is defined by a specific genetic change: a piece of one chromosome breaks off and joins another, which leaves a growth gene called MYC permanently switched on. That is what makes the cells divide so quickly.

Three forms are recognised, and they are different enough that statistics about one do not transfer to another. The endemic form is most common in children in equatorial Africa, is linked to both malaria and Epstein-Barr virus, and classically involves the facial bones or jaw. The sporadic form is the one seen in the UK, the US and Europe, and classically involves the abdomen. A third form occurs in people whose immune system is suppressed — by HIV, or by medication after an organ transplant.

Around 260 people are diagnosed each year in the UK, about 2% of all non-Hodgkin lymphoma. It is the most common non-Hodgkin lymphoma in children in the UK, and it affects more males than females.

Around one in three people have lymphoma cells in their bone marrow when it is diagnosed.

Epstein-Barr virus is associated with almost all endemic cases in Africa, and with roughly 15% of cases in Europe and the United States.

That association needs its counterweight in the same breath, and Cancer Research UK gives it: Epstein-Barr virus is extremely common in the general population, and the overwhelming majority of people who carry it never develop lymphoma. A past glandular fever infection does not explain this diagnosis.

In the endemic setting, malaria is part of the picture too rather than the virus alone.

The immunodeficiency-associated form occurs in people living with HIV or taking immune-suppressing medication after an organ transplant.

For the form most readers of this page will have, no cause an individual could have avoided is identified in these sources.

The pace is the defining feature. Symptoms usually develop over days to weeks rather than months.

What people notice is swollen lymph nodes, abdominal pain, nausea, diarrhoea, fever, night sweats and weight loss.

It carries a real risk of reaching the brain or the fluid around the spinal cord — an estimated 20% to 30% over the course of the illness. That is why preventive treatment aimed at the nervous system is built into the standard regimens rather than added if something goes wrong.

There is a small group defined by a second genetic change alongside the first, and their outlook is very different and much worse. That is a distinct genetic group rather than typical Burkitt lymphoma.

Treatment is short-course intensive combination chemotherapy given with the aim of cure, usually combined with rituximab — an antibody that targets B cells.

Preventive treatment aimed at the nervous system is routine. It is usually given by lumbar puncture, injecting chemotherapy directly into the fluid around the spinal cord. Repeated lumbar punctures are a normal part of the plan rather than a sign anything has gone wrong.

One thing is worth understanding before it happens, because it is frightening otherwise. Because these cells divide so fast, they also die fast once treatment starts, releasing a great deal of chemical material into the blood at once. That can overwhelm the kidneys and affect the heart, and it has a name: tumour lysis syndrome. It is anticipated and actively prevented — heavy intravenous fluids plus a drug to protect the kidneys — and it is a consequence of the treatment working rather than failing.

The first days of treatment therefore involve close monitoring and frequent blood tests.

Treatment is intensive but short. Lower-risk disease can be treated with as few as three cycles. That is a materially different shape of experience from the months or years some other blood cancers involve.

A transplant is not part of first-line treatment. The NCI lists transplant only among the options for disease that comes back or does not respond, alongside further chemotherapy, antibody drugs and CAR T-cell therapy.

There is often very little time between being well and being in hospital on chemotherapy. Symptoms build over days, the diagnosis is made quickly, and treatment starts urgently. People describe that speed as the hardest part of the beginning.

The first days are intensive: heavy fluids, kidney-protecting drugs, frequent blood tests, and close observation.

Repeated lumbar punctures are part of the treatment rather than a complication.

And then it is comparatively short. Lymphoma Action states that this lymphoma is usually treated with the aim of curing it, that many people go into complete remission, that most children treated for it are cured, and that the outcome for younger adults is very good. Cancer Research UK declines to give a survival figure at all, saying it depends on too many factors and pointing the reader to their own team.

We have not put a paediatric survival figure on this page. The one that circulates covers all childhood lymphomas pooled together in high-income countries, and applying it to an adult with this diagnosis would be a false promise.

Nothing, in the treatment given at diagnosis. This is the disease in this part of the library where the honest answer is that chemotherapy is the treatment given with the aim of cure, and a donor is not part of it.

We checked this rather than assumed it. A full-text search of EBMT’s 2025 transplant recommendations finds no mention of Burkitt lymphoma anywhere — not in the adult table, not in the paediatric table, not in the narrative. There is no transplant indication for it to cite.

If the lymphoma comes back or does not respond, a transplant is one of the options, and at that point it may or may not involve a donor. The NCI lists both kinds without stating a preference, and the patient-facing sources say only "a stem cell transplant". We are not going to resolve that ambiguity by guessing which one they mean.

So if you are newly diagnosed with this, nobody is starting a donor search, and joining a registry is not something you need to think about on your own account.