Therapeutic approaches

Treatment of Burkitt lymphoma/diffuse small noncleaved-cell lymphoma involves aggressive multidrug regimens in combination with rituximab, similar to those used for the advanced-stage aggressive lymphomas (DLBCL).[54-57] Aggressive combination chemotherapy, which is modeled after that used in childhood Burkitt lymphoma, has been successful for adult patients with more than 60% of advanced-stage patients free of disease at 5 years.[58-61] Adverse prognostic factors include bulky abdominal disease and a high serum LDH level. Patients with Burkitt lymphoma have a 20% to 30% lifetime risk of CNS involvement. Prophylaxis with intrathecal chemotherapy is required as part of induction therapy.[62] Patients with HIV-associated Burkitt lymphoma also benefit from less-toxic modification of the aggressive multidrug regimens in combination with rituximab.[63][Level of evidence C3] For more information, see Primary Central Nervous System Lymphoma Treatment and AIDS-Related Lymphoma Treatment.