Burkitt’s lymphoma: symptoms and treatment


Burkitt’s lymphoma is an extremely high degree of non-Hodgkin’s lymphoma, which develops from B-lymphocytes. The peculiarity and key danger of this lymphoma is its ability to spread not only in the lymphatic system, but also beyond its limits. As a rule, if it gets into the bone marrow or spinal fluid, a person expects a disappointing prognosis. Without qualified care and properly prescribed therapy, Burkitt’s lymphoma is fatal.

Among malignant tumors, this lymphoma takes the sixth place in mortality. It is prevalent mainly in Central Africa and the USA. On the territory of Russia, this ailment is extremely rare. Burkitt’s lymphoma can appear and develop at any age, but most often it affects children and young men. In addition, it is often observed in people infected with the immunodeficiency virus.

Etiology

Scientists suggest that viruses play a significant role in the appearance and development of Burkitt’s lymphoma, because they affect tumor growth. According to research, about 95% of African boys and girls with endemic Burkitt’s lymphoma are infected with Epstein-Barr virus.

This virus was first recorded in an African with Burkitt’s lymphoma, in the sixties of the last century. It binds in a special way to the receptor that is located on the surface membrane of B-lymphocytes. As a result, the B-lymphocyte is stimulated, and the expression of the receptor is increased. In addition, some of the B cells lose their ability to permanently proliferate in the culture. Experts suggest that just these cells and begin to progress malignantly.

In addition, the Epstein-Barr virus causes infectious mononucleosis, and this ailment is very similar to the abortive flow of Burkitt’s lymphoma. In addition to this virus, there are other causes of the appearance and development of Burkitt’s lymphoma:


  • hereditary predisposition. This disease is often observed in men born in such families, whose representatives traced the deficiency of the immune system. These patients have a genetic defect in immunoregulation, so their body is not able to withstand the Epstein-Barr virus;
  • Mononucleosis. Even if the patient is cured of this disease, he is still considered to be the carrier of the Epstein-Barr virus. Consequently, Burkitt’s lymphoma has every chance of developing in his body;
  • ionizing radiation, a bad ecological situation, chemical carcinogens. These are the reasons that are common for the development of most neoplastic ailments.

Symptoms

Burkitt’s lymphoma cells accumulate in the lymph nodes, which leads to their increase. Because it is an aggressive non-Hodgkin’s lymphoma, it grows very rapidly.

Main symptoms:


  1. neoplasm of the jaw extending not only to the salivary gland, but also to the thyroid gland
  2. deformation of the nose and jaw;
  3. tooth loss
  4. infiltration of soft tissues
  5. difficulty swallowing and breathing
  6. general toxic syndrome. This symptom is observed at the very beginning of the disease. Some people do not pay any attention to it, because bad health and fever occur almost in any infectious disease. Such an attitude towards one’s own organism is fraught with sad consequences, because any infectious disease is dangerous for humans, especially Burkitt’s lymphoma;
  7. defeat of bones, which leads to fractures, paresis and paralysis. These symptoms are observed in the generalized course of the disease.

The greatest danger is the abdominal form of lymphoma. It is very fast and very difficult to diagnose. Because of this, it is difficult to determine the forecast of its development. This form of the disease affects the liver, intestines, pancreas, kidneys. The person has symptoms such as abdominal pain, jaundice, fever, severe weight loss. In some cases, there are symptoms of dyspepsia: discomfort in the epigastric zone, early satiety, nausea, bloating.





Diagnostics

A specialist diagnoses and prescribes treatment based on the results of such studies:


  • autopsy Often, Burkitt’s lymphoma is detected in the kidneys, retroperitoneal lymph nodes, pancreas, jaw, stomach, meninges. As a rule, lymphoma does not develop in peripheral and / or mediastinal lymph nodes, as well as in the pharyngeal lymphoid ring. The main difference between Burkitt’s lymphoma and lymphosarcoma is the presence of immature lymphoblasts in the tumor. In the nuclei of these cells, chromatin is in the form of small grains
  • Electron microscopy. Vacuolated histiocytes clearly stand out against all the tumor cells. In the cytoplasm of lymphoid cells is an impressive number of lipids, which stain cells and create a picture of the «starry sky.» In addition, the protrusion of the cytoplasm with parts of the nucleus and infected cells is detected;
  • Molecular hybridization.

Treatment

Despite aggressiveness and terrible symptoms, this lymphoma can be defeated if you go to the doctor in time and go through the treatment prescribed by him. It is proved that timely diagnosis and intensive complex treatment lead to long-term remissions, which last for several months. In addition, there have been recorded cases of complete cure of patients.


  1. chemotherapy. This treatment involves the use of antitumor drugs that not only take away the symptoms of the disease, but also completely destroy the tumor cells. The danger of chemotherapy lies in the fact that the remedies that get rid of infected cells also damage normal cells. As a result, the bone marrow, hair follicles and oral and gastrointestinal mucosa are affected. The presence of side effects and their severity depends on the type, dose and duration of drug administration. Typically, such treatment is carried out in the form of courses that involve breaks in two to four weeks. Some time after the termination of chemotherapy, side effects (alopecia, the development of sores in the mouth, increased susceptibility to viruses, decreased appetite) disappear. Now many specialists write out pharmacological agents that relieve the patient from complications of chemotherapy;
  2. Antiviral drugs. Recently, antitumor drugs have been supplemented with antiviral drugs. It has already been proven that foscarnet and ganciclovir improve the results of therapy. The action of brivudine, lobucavir, cidofovir, adevofir is under study;
  3. immunomodulators. Complex treatment involves the reception of recombinant interferons in large doses. For example, roferon is first given intramuscularly every day, and then the dose is reduced to two times in seven days. Such treatment lasts no less than six months;
  4. Surgical treatment. If the patient did not pay attention to the signs of the disease or whether it initially developed too quickly, drug therapy will not yield the expected results. In this case, the specialists decide to conduct the operation.

After each block of chemotherapy, the patient is given directions for a follow-up examination. It includes the study of LDH of blood serum, ultrasound and computed tomography of the organs of the abdominal cavity and kidneys, examination of the bone marrow. So doctors determine the prognosis of the development of the disease and the chances of a person to recover.

When the treatment is fully completed, a person comes to the control examination once every three months during the first year. So experts determine whether the symptoms of the disease have not reappeared. Through the examination, doctors are given the opportunity to schedule treatment in time and prevent the development of the disease. At the end of the first year, a person undergoes a follow-up examination every six months.

If a person turns to a doctor when Burkitt’s lymphoma has already spread to the bone marrow, central nervous system and blood, the prognosis is extremely disappointing. As a rule, such patients can not be saved anymore.