Treatment & Care
What is the treatment for Burkitt’s lymphoma?
Specific treatment for Burkitt’s lymphoma will be determined by your child's physician based on:
- your child's age, overall health and medical history
- the extent of the disease
- your child's tolerance for certain medications, procedures or therapies
- how your child's physician expects the disease to progress
- your opinion or preference
Treatment components may include the following (alone or in combination):
Chemotherapy is a drug treatment that works by interfering with the cancer cell's ability to grow or reproduce. Because Burkitt's lymphoma grows so quickly, chemotherapy treatment may be intense and last 6-8 months. Treatment may include drugs given directly to central nervous system (CNS) through the blood stream or a small puncture in the spine to prevent cancerous cells from multiplying in the spinal cold or brain.
How is chemotherapy given?
Different chemotherapies may be given:
- as a pill to swallow
- as an injection into the muscle or fat tissue
- intravenously (directly to the bloodstream, also called IV)
- intrathecally (directly into the spinal column with a needle)
How is chemotherapy used?
This depends on many factors. Some things to keep in mind:
- A number of combinations of chemotherapy drugs are currently being used to stabilize and, in some cases, to shrink the size of the tumor.
- Depending on the type of cancer, chemotherapy drugs may be given in a specific order.
- Chemotherapy may be used alone for some types of cancer, or in conjunction with other therapy such as radiation or surgery.
Does chemotherapy come with bad side effects?
While chemotherapy can be quite effective, the drugs do not differentiate normal healthy cells from cancer cells. Because of this, there can be many adverse side effects during treatment. Being able to anticipate these side effects can help your child, family and your child’s health care team prepare for and sometimes prevent these symptoms from occurring.
Surgery usually plays a limited role in the treatment of lymphoma. In some instances, a child may need to have a tumor removed. This may be the case if, for example, the tumor originates in the mediastinum region, where it may compress your child’s airway and/or heart and major vessels. Surgery in this area may entail considerable risk, and must be carefully orchestrated between the surgeon, oncologist and anesthesiologist.
Radiation therapy uses high-energy rays (radiation) from a specialized machine to damage or kill cancer cells and shrink tumors. This type of therapy is most effective when there is a bulky, localized tumor that will not respond completely to chemotherapy.
Stem cells are a specific type of cell from which all blood cells develop. They can develop into red blood cells to carry oxygen, white blood cells to fight disease and infection, and platelets to aid in blood clotting. Stem cells are found primarily in the bone marrow, but some also circulate in the blood stream.
- Treatment may begin with high-dose chemotherapy (perhaps combined with radiation therapy) to destroy all of the bone marrow, stem cells and cancerous cells, in your child’s body.
- Then, healthy stem cells collected from another individual whose tissue is the same as, or almost the same as, the patients are used. This is called allogeneic transplantation. This is the most common type of stem cell transplant used to treat lymphoblastic lymphoma. Often, stem cell transplant is most appropriate for patients who have recurrent or drug-resistant disease.
- Sometimes, your child’s own stem cells are collected prior to intensive treatment and used to supplement recovery after a particularly aggressive course of treatment. Through this procedure, stem cells are taken, treated in a laboratory to kill any remaining cancer cells, and kept in frozen storage for later use. After chemotherapy and/or radiation therapy, the saved stem cells are thawed and given back to grow new bone marrow and other stem cells. This is known as autologous transplantation.
Medications including antibiotics may be given if your child experiences pain, fever, infection and nausea and/or vomiting.
Continuous follow-up care
Your child’s health will be closely monitored to determine response to treatment, detect recurrent disease and manage late effects of treatment.
What is the long-term outlook for a child with Burkitt’s lymphoma?
Your child’s prognosis greatly depends on:
- the extent of the disease
- presence or absence of metastasis
- response to therapy
- your child’s age and overall health
- tolerance of specific medications, procedures or therapies
- new developments in treatment
As with any cancer, prognosis and long-term survival can vary greatly. Prompt medical attention and aggressive therapy are important for the best prognosis, and continuous follow-up care is essential. New methods are continually being discovered to improve treatment and decrease side effects of the treatment for the disease.
What is the latest research on Burkitt’s Lymphoma?
A variety of chemotherapeutic regimens have been evaluated in the treatment of newly diagnosed high-grade gliomas.
- While studies in adults have suggested that procarbazine, vincristine and CCNU (PVC) produce modest responses in grade III gliomas, this has not been demonstrated for pediatric cases or for grade IV tumors.
- Several other regimens have also produced responses, but none has improved survival.
- Increased doses of chemotherapy in the setting of autologous bone marrow transplant have also not produced notable advantage.
The Dana-Farber/Children's Hospital program is part of the Children's Oncology Group, a national group of pediatric oncologists whose work includes investigational treatments for newly diagnosed patients with non-Hodgkin lymphoma and those who experience relapse. Studies also seek to improve the supportive care of patients undergoing treatment.
One area of treatment under investigation is biological therapy or immunotherapy, the use of drugs that seem to slow the growth of cancer cells while stimulating and strengthening the body's own immune system. Improvements are also occurring in the area of stem cell transplant, where researchers are finding better ways to improve pre-transplant treatment, broaden the range of compatible donors, and more effectively remove cancerous cells from patient's own bone marrow.