Lessons from clinical trials in African Burkitt lymphoma

  title={Lessons from clinical trials in African Burkitt lymphoma},
  author={Ian T. Magrath},
  journal={Current Opinion in Oncology},
  • I. Magrath
  • Published 1 September 2009
  • Medicine
  • Current Opinion in Oncology
Purpose of review The center of gravity of the AIDS epidemic has moved – in 2007, 67% of all persons living with HIV infection and 72% of all deaths from AIDS occurred in Africa. The present review focuses on the treatment of an AIDS-defining malignancy, Burkitt lymphoma, since the discovery of the tumor in 1958 to provide a backdrop to the increasing necessity of dealing with AIDS-associated Burkitt lymphoma in Africa. Recent findings In Africa, it appears that AIDS-associated Burkitt lymphoma… 

Controversies in the treatment of Burkitt lymphoma in AIDS

  • A. Noy
  • Medicine, Biology
    Current opinion in oncology
  • 2010
Advances are being made in HIV-Burkitt lymphoma, but future studies need to incorporate the expanding understanding of biology to improve efficacy and reduce toxicity, preferably by integrating a biologic approach to this curable disease.

Towards Curative Therapy in Burkitt Lymphoma: The Role of Early African Studies in Demonstrating the Value of Combination Therapy and CNS Prophylaxis

This paper describes the treatment of Burkitt lymphoma from the time of its discovery in Africa up to the present and suggests that Rituximab may improve the results in some patient groups and allow less intensive therapy without a reduction in survival in others.

Treatment of Burkitt lymphoma in equatorial Africa using a simple three‐drug combination followed by a salvage regimen for patients with persistent or recurrent disease

The results reported here for 356 patients have demonstrated marked improvement in survival through the use of a uniform treatment protocol consisting of cyclophosphamide, methotrexate, vincristine, and intrathecal therapy, and the introduction of non‐cross resistant second‐line (salvage) therapy.

Denis Burkitt and the African lymphoma

The African lymphoma has taught us much, but there is a great deal still to be learned.

Paradigms and Controversies in the Treatment of HIV-Related Burkitt Lymphoma

The potential risks and benefits of commonly used regimens are reviewed, along with a discussion of controversial issues in the practical management of HIV-BL, including concurrent anti-retroviral therapy, treatment of relapsed and/or refractory disease, and the role of stem cell transplantation.

Lymphomas in sub‐Saharan Africa – what can we learn and how can we help in improving diagnosis, managing patients and fostering translational research?

The results on the diagnostic accuracy and on the distribution of different lymphoma subsets in sub‐Saharan Africa were based on a review undertaken by a team of lymphoma experts on 159 fine needle aspirate samples and 467 histological samples during their visit to selected sub-Saharan African centres is presented.

Therapeutic Approaches to Burkitt’s Lymphoma

The treatment of Burkitt lymphoma has advanced over the last 50 years due to the pivotal work of Dr. Denis Burkitt and his colleagues, and management of treatment toxicities such as acute tumor lysis syndrome continues to be an important point of emphasis.

Therapeutic interventions for Burkitt lymphoma in children.

A preference in more recent studies for less aggressive care options for treatment of BL is noted, however, the evidence for the relative effectiveness of interventions to treat BL is not strong as studies were small, underpowered and prone to both systematic and random error.


HIV is associated with KS and BL among children with cancer in South Africa and the proportion of children disease-free at end of follow-up is significantly lower in children infected with HIV while theportion of deaths due to toxicity is significantly higher.

Tumor lysis syndrome as a risk factor for very early mortality in HIV-associated non-Hodgkin’s lymphoma: A 10-year single-center experience

Management of the early treatment phase of HIV-associated NHLs remains a major challenge, and careful intervention to patients with TLS might be the key to improve treatment outcomes.



AIDS-associated cancer in developing nations

It is apparent that as the AIDS pandemic proceeds, the burden of neoplastic diseases is increasing in developing nations, and guided prevention and therapeutic interventions suitable for the resource-constrained setting are clearly needed.

African Burkitt's lymphoma. History, biology, clinical features, and treatment.

  • I. Magrath
  • Medicine
    The American journal of pediatric hematology/oncology
  • 1991
Small, noncleaved cell lymphoma is the latest histological designation of the category of lymphomas that includes Burkitt's lymphoma, which has become notorious because of its high incidence in individuals infected with the human immunodeficiency virus.

Treatment results of 54 American patients with Burkitt's lymphoma are similar to the African experience.

  • J. Ziegler
  • Medicine
    The New England journal of medicine
  • 1977
Complete response rates, relapse frequency and survival in American patients are similar to results in Africa, and no differences in survival were detected between patients treated at the National Institutes of Health and those treated in regional institutions on either protocol.

Chemotherapy of Burkitt's Lymphoma

It would seem that potassium iodide may be a valuable adjuvant to cyclophosphamide in the treatment of this and other tumours.

Malawi pilot study of Burkitt lymphoma treatment.

It is possible to administer less intense and less costly multiagent chemotherapy to children with BL in a developing society with acceptable EFS rates.

Advances in the management of HIV-related non-Hodgkin lymphoma

Outcomes of HIV- non-Hodgkin lymphoma are improving with the routine use of highly active antiretroviral therapy and combination chemotherapy, and autologous stem cell transplantation should be considered for selected patients with relapsed or refractory HIV-non-Holland lymphoma.

Treatment of Burkitt's tumor with cyclophosphamide

This study showed that single doses of CTX are capable of inducing long remissions in patients with localized disease and the prognosis is improved in stage III patients who undergo surgical reduction of tumor bulk prior to chemotherapy.

Adult Burkitt's lymphoma in patients with and without human immunodeficiency virus infection in Kenya

There is an approximate 3‐fold increase in the incidence of adult BL during the time period of this study, which is attributable to the AIDS epidemic, and HIV infection is virtually excluded in an adult patient without peripheral lymphadenopathy and biopsy‐proven BL in Kenya.

Adult Burkitt leukemia and lymphoma.

Although Burkitt lymphoma cells are extremely chemosensitive, biologically targeted therapies should be developed because current treatment options are suboptimal for patients with poor prognostic features or in the setting of relapsed disease.