Burkitt Lymphoma Essay

Burkitt Lymphoma was mapped out in geographic distribution a cross(a) Africa by Dr. Denis Parsons Burkitt (Huang 2005). This distemper is a mellow grade B- st altogether neoplasm, which has cardinal major old age the indigenous (i. e. African nature) and the non-endemic (i. e. fitful nature). Burkitt Lymphoma is mainly found as childishness neoplasm, yet it is, also, discovered in grown patients (Huang 2005). This Lymphoma type is one of the fastest evolution malignancies in humans, and it has a high increase fraction (Huang 2005).Burkitt Lymphoma is a monoclonal proliferation of B lymphocytes that is characterized by sm alone non-cleaved cells is appe ard to be ordered in appearance (Huang 2005). It produces a diffuse pattern of tissue amour. While below the microscope, this lymphoma is characterized by the presence of a starlit sky appearance due to disordered macroph get alongs with phagocyte cell debris this is observed in other highly proliferate lymphomas, as well (Huang 2005).The African comprise of this lymphoma most often involves the maxilla or mandible and the involvement of type AB organs, for compositors case the kidneys, ovaries, and retroperitoneal structures, but is somewhat less(prenominal) commonalty (Huang 2005). On the contrary, the sporadic form involves the group AB organs distal ileum, cecum, and mesentery. The involvement of pelvic organs or facial fig outs is high-minded (Huang 2005).The majority of Burkitt Lymphomas carry a translation of the c-myc oncogene from chromosome eight to the immune serum globulin (lg) heavy-chain region on chromosome fourteen (t 814)or a light-chain loci chromosome two (t 82)or chromosome xxii (t 822) (Huang 2005). Within the African form of Burkitt Lymphoma, The Epstein-Barr virus (EBV) has been implicated strongly and the kind in the sporadic form is less exculpated (Huang 2005). Epstein-Barr virus is associated in almost twenty percent of sporadic cases. The r are cases in ad ult are unremarkably associated with immunodeficiency, preponderantly AIDS, respectively (Huang 2005).Some get down reasoned, the host is unable to generate decent T-lymphocyte response or Epstein-Barr specific cytoxic T-cells (Huang 2005). This by and bywards results in excessive B cell proliferation. The lymphocytes bedevil receptors in particular for the Epstein-Barr virus and are the specific targets (Huang 2005). In the African form, the hosts are believed to be unable to increase a suitable immune response to prime Epstein-Barr infection. This is possible due to coexistent malaria or other infections that are immunosuppressive, also (Huang 2005).Burkitt Lymphoma is an super rare crabby person in the joined States, with besides 100 new cases apiece year. However, Burkitt Lymphoma is endemic in many regions of equatorial Africa and other tropical regions between latitudes 10 south and 10 north. The frequency of this cancer in these endemic regions is 100 per one th ousand million children (Huang 2005). The male-to-female ratio is 2-31, and the most common a in children is seven years of age is the mean in African, eleven years of age is the current mean out of doors of Africa (Huang 2005). Prior to aggressive therapeutic give-and-take program, children with Burkitt Lymphoma died fastly.However, with a crew of chemotherapy and CNS prophylaxis the selection of the fittest rate has increase to at least sixty percent and patients with a control disease now rent a ninety percent chance of survival (Huang 2005). Patients with bone marrow and CNS involvement have a poor prognosis. Adults with the disease, especially those in the advanced stage, do to a greater extent poorly than affected children (Huang 2005). In the African form, patients most often present lummox of the mandible and other facial bone with the loosening of teeth, and swelling of the lymph nodes, which have rapid growth below the mandible (Huang 2005).Patients who have the s poradic form are commonly presented with group AB tumors that cause swelling and distract in the affected area hardly a(prenominal) patients have symptoms of bowel obstruction that is caused by tumor growth (Huang 2005). Burkitt tumors growth is staggeringly rapid in nature, and patients have clear metabolic derangement and renal juncture impairment and may include extradural skunk, skin nodules, central nervous clay symptoms, and bone marrow involvement (Huang 2005). uncommon cases of Burkitt lymphoma can present acute leukemia with fever, anemia, bleeding, and adenopathy (Huang 2005). initiative indicators of Burkitt Lymphoma include soft tissue mass associated with involvement of the mandible, enlarged cervical lymph nodes, abdominal masses, and ascites (Huang 2005). Moreover, the exact cause and mechanisms of this lymphoma are forthwith unknown. It is important that Burkitt Lymphoma is distinguished from other abdominal tumors in childhood, such as Wilms tumor, neurob lastoma, and computer peripheral neuroectodermal tumor (Huang 2005). Also, in spite of appearance the bone marrow, B and T precursors and myeloid leukemia must be distinguished (Huang 2005).Systemic chemotherapy is the sermon for this lymphoma is all its stages. The survival rate ultimately depends on the stage at initial diagnosis (Huang 2005). Patients with a localized infection move well to chemotherapy, with an excellent rate of survival. Cyclophosphamide therapy has been cure for eighty percent of children in Africa with the archeozoic stage of Burkitt Lymphoma (Brock 1996). The effect of cyclophosphamide is due to its metabolite phosphoramide mustard greens (Brock 1996). The metabolite is only formed in cells which have low levels of aldehyde dehydrogenase.The Phosphoramide mustard forms deoxyribonucleic acid cross links between and within DNA strands this leads to cell death (Brock 1996). However, combination chemotherapy has change treatment results. Intensive, sh ort-duration, alkylator-based regimens are necessary for all patients with the sporadic form (Huang 2005). In patients with AIDS, Burkitt Lymphoma is in advanced stage at metre of diganosis and tends to involve extranodal sites (Huang 2005). Furthermore, because of beneathlying immunodeficiency and leukopenia, these patients tolerate general chemotherapy very poorly.A patients expiration usually follows shortly after diagnosis (Huang 2005). A nine hebdomad regiment of cyclophosphamide, doxorubicin, vincristine, and prednisone was effective for primal stages of the disease and a longer regimen included a combination with shaft of light (Link et al. 1997). The cure rate more than exceeded ninety percent with minimal toxicity. Therefore, a lesser-intensive therapy is under evaluation as a potentially effective means to steer clear of unnecessary toxicity for patients with early stages (Link et al. 1997).This may achieve similar cure place obtained with prolonged treatment (Link et al. 1997). Vanderbilt Medical philia has reported results for patients with poor-prognosis non-Hodgkin Lymphoma, which includes Burkitt Lymphoma, using a high dose and short-duration combined chemotherapy comprising cyclophosphamide, etoposide, doxorubicin, vincristine, bleomycin, methotrexate with leucovorin rescue, prednisone (Huang 2005). Burkitt Lymphoma patients have a high stake of tumor lysis syndrome before chemotherapy is started because of rapid tumor cell turnover (Huang 2005).This is a life-threatening situation and should be anticipated and address to the patient prior to beginning treatment (Huang 2005). discussion should be preformed at a proper facility with renal dialysis is available, predominantly for patients with progression of disease (Huang 2005). Treatment of recurrent Burkitt lymphoma is difficult. Bone marrow transplantation is the only hope of long-term survival for these patients (Huang 2005). Burkitt Lymphoma is a high grade B-cell neoplasm, whic h is highly endemic in Central Africa and sporadic end-to-end other countries (Huang 2005). This disease is the fastest maturement malignancy in children.A combination chemotherapy is the most effect mode of treatment and has high cure range within early stages, and the moderate cure rates for progressed patients (Huang 2005). References Brock N. (1996). The history of the oxazaphosphorine cytostatics. Cancer. 78542-7. Link MP, Shuster JJ, Donaldson SS, et al. (1997). Treatment of children and young adults with early-stage non-Hodgkins lymphoma. New England daybook of Medicine. 30 October 1997 337(18) 1259-66. Huang, H, MD, PhD et al.. (2005). Burkitt Lymphoma. eMedicine. Date visited 19 April 2006. http//www. emedicine. com/med/topic256. htm