Skip to content

Non-Hodgkin's Lymphoma

Font Size

Adult Non-Hodgkin Lymphoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Treatment for Diffuse Small Noncleaved-Cell / Burkitt Lymphoma

Diffuse small noncleaved-cell/Burkitt lymphoma typically involves younger patients and represents the most common type of pediatric NHL.[1]

Standard Treatment Options for Diffuse Small Noncleaved-Cell/Burkitt Lymphoma

Recommended Related to Non-Hodgkin's Lymphoma

Follicular Lymphoma

Follicular lymphoma is a cancer that affects white blood cells called lymphocytes. They help your body fight infections. There are two types of lymphomas: Hodgkin's and non-Hodgkin's, based on the kind of white blood cell they affect. Follicular lymphoma is a non-Hodgkin's lymphoma. When you have follicular lymphoma, the sick blood cells can travel to many parts of your body, such as your organs, bone marrow, and lymph nodes (pea-sized glands in your neck, groin, and under your arms that are part...

Read the Follicular Lymphoma article > >

Standard treatment options for diffuse small noncleaved-cell/Burkitt lymphoma include the following:

  1. Aggressive multidrug regimens.
  2. Central nervous system (CNS) prophylaxis.

Aggressive multidrug regimens

Standard treatment for diffuse small noncleaved-cell/Burkitt lymphoma is usually with aggressive multidrug regimens similar to those used for the advanced-stage aggressive lymphomas (such as diffuse large cell).[2,3,4] In some institutions, treatment includes the use of consolidative bone marrow transplantation.[5,6] Adverse prognostic factors include bulky abdominal disease and high serum lactate dehydrogenase.

Evidence (aggressive multidrug regimens):

  • An intensive clinical trial (CLB-9251 [NCT00002494]) used aggressive combination chemotherapy patterned after that used in childhood Burkitt lymphoma and has been very successful for adult patients.[7,8,9,10,11] More than 60% of advanced-stage patients were free of disease at 5 years.[7,8,9,10,11,12]

Central nervous system (CNS) prophylaxis

Patients with diffuse small noncleaved-cell/Burkitt lymphoma have a 20% to 30% lifetime risk of CNS involvement. CNS prophylaxis with methotrexate is recommended for all patients, usually given as four to six intrathecal injections.[13] (Refer to the PDQ summary on Adult Acute Lymphoblastic Leukemia Treatment for more information).

Evidence (CNS prophylaxis):

  • In a series of 41 patients treated with systemic and intrathecal chemotherapy, 44% of those who presented with CNS disease and 13% of those who relapsed with CNS involvement became long-term disease-free survivors.[14] CNS relapse patterns were similar whether or not patients received radiation therapy, but increased neurologic deficits were noted among those patients who received radiation therapy.

Current Clinical Trials

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with adult Burkitt lymphoma. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.

General information about clinical trials is also available from the NCI Web site.

References:

  1. Blum KA, Lozanski G, Byrd JC: Adult Burkitt leukemia and lymphoma. Blood 104 (10): 3009-20, 2004.
  2. Longo DL, Duffey PL, Jaffe ES, et al.: Diffuse small noncleaved-cell, non-Burkitt's lymphoma in adults: a high-grade lymphoma responsive to ProMACE-based combination chemotherapy. J Clin Oncol 12 (10): 2153-9, 1994.
  3. McMaster ML, Greer JP, Greco FA, et al.: Effective treatment of small-noncleaved-cell lymphoma with high-intensity, brief-duration chemotherapy. J Clin Oncol 9 (6): 941-6, 1991.
  4. Thomas DA, Faderl S, O'Brien S, et al.: Chemoimmunotherapy with hyper-CVAD plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia. Cancer 106 (7): 1569-80, 2006.
  5. Freedman AS, Takvorian T, Anderson KC, et al.: Autologous bone marrow transplantation in B-cell non-Hodgkin's lymphoma: very low treatment-related mortality in 100 patients in sensitive relapse. J Clin Oncol 8 (5): 784-91, 1990.
  6. Sweetenham JW, Pearce R, Philip T, et al.: High-dose therapy and autologous bone marrow transplantation for intermediate and high grade non-Hodgkin's lymphoma in patients aged 55 years and over: results from the European Group for Bone Marrow Transplantation. The EBMT Lymphoma Working Party. Bone Marrow Transplant 14 (6): 981-7, 1994.
  7. Soussain C, Patte C, Ostronoff M, et al.: Small noncleaved cell lymphoma and leukemia in adults. A retrospective study of 65 adults treated with the LMB pediatric protocols. Blood 85 (3): 664-74, 1995.
  8. Magrath I, Adde M, Shad A, et al.: Adults and children with small non-cleaved-cell lymphoma have a similar excellent outcome when treated with the same chemotherapy regimen. J Clin Oncol 14 (3): 925-34, 1996.
  9. Adde M, Shad A, Venzon D, et al.: Additional chemotherapy agents improve treatment outcome for children and adults with advanced B-cell lymphomas. Semin Oncol 25 (2 Suppl 4): 33-9; discussion 45-8, 1998.
  10. Hoelzer D, Ludwig WD, Thiel E, et al.: Improved outcome in adult B-cell acute lymphoblastic leukemia. Blood 87 (2): 495-508, 1996.
  11. Lee EJ, Petroni GR, Schiffer CA, et al.: Brief-duration high-intensity chemotherapy for patients with small noncleaved-cell lymphoma or FAB L3 acute lymphocytic leukemia: results of cancer and leukemia group B study 9251. J Clin Oncol 19 (20): 4014-22, 2001.
  12. Mead GM, Sydes MR, Walewski J, et al.: An international evaluation of CODOX-M and CODOX-M alternating with IVAC in adult Burkitt's lymphoma: results of United Kingdom Lymphoma Group LY06 study. Ann Oncol 13 (8): 1264-74, 2002.
  13. Rizzieri DA, Johnson JL, Niedzwiecki D, et al.: Intensive chemotherapy with and without cranial radiation for Burkitt leukemia and lymphoma: final results of Cancer and Leukemia Group B Study 9251. Cancer 100 (7): 1438-48, 2004.
  14. Magrath IT, Haddy TB, Adde MA: Treatment of patients with high grade non-Hodgkin's lymphomas and central nervous system involvement: is radiation an essential component of therapy? Leuk Lymphoma 21 (1-2): 99-105, 1996.

WebMD Public Information from the National Cancer Institute

Last Updated: February 25, 2014
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
1
Next Article:

Today on WebMD

stem cells
What are they and why do we need them?
Lung cancer xray
See it in pictures, plus read the facts.
 
sauteed cherry tomatoes
Fight cancer one plate at a time.
Ovarian cancer illustration
Do you know the symptoms?
 
Vitamin D
SLIDESHOW
New Treatments For Non-Hodgkins Lymphoma
FEATURE
 
Lifestyle Tips for Depression Slideshow
SLIDESHOW
Pets Improve Your Health
SLIDESHOW
 

WebMD Special Sections