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Treatment Advances for Burkitt Lymphoma

Issa Hajji Ally, Ting Yang and Jianda Hu

Burkitt Lymphoma (BL) is an uncommon but highly aggressive B-cell Non-Hodgkin Lymphoma (NHL). It is a subtype of mature B-cell lymphoma and can be treated successfully within a short period via high-intensity chemotherapeutic regimens. Diagnosis and initial work-up must be completed rapidly to begin treatment due to high proliferation. BL is associated with the Epstein-Barr Virus (EBV) and with a chromosomal translocation that activates the c-MYC gene. However, by implementing chemotherapy regimens, complete remission and overall survival for young patients with BL remains high. In contrast, in elderly patients and those with relapsed/refractory disease, the prognosis remains a medical challenge.
Rituximab, the chimeric monoclonal antibody against CD20, has improved the clinical management of B-cell malignancies. Because BL expresses a CD20 positive marker in their cell surfaces, rituximab has been shown to improve patient survival rate. However, because resistance can still occur, further treatment and evaluation is required, including inhibition of the MYC proto-oncogene through the use of bromodomain inhibitors. In this review, we highlight the treatment advances and progress in BL.