College Of Medicine, Blantyre, Malawi.
Lancet. 2012 Mar 31;379(9822):1234-44. doi: 10.1016/S0140-6736(11)61177-X. Epub 2012 Feb 13.
Burkitt's lymphoma is a highly aggressive B-cell non-Hodgkin lymphoma and is the fastest growing human tumour. The disease is associated with Epstein-Barr virus and was one of the first tumours shown to have a chromosomal translocation that activates an oncogene (c-MYC). Burkitt's lymphoma is the most common childhood cancer in areas where malaria is holoendemic. The incidence is very high in immunosuppressed patients in non-endemic areas, especially when associated with HIV infection. Outcome with intensive chemotherapy has improved and is now excellent in children, but the prognosis is poor in elderly adults. The success of intensive treatment relies on good supportive care. The therapy offered in oncology units in low-income countries is not as aggressive as in centres in high-income countries and outcomes are less successful. Adjuvant monoclonal antibody therapy with rituximab shows promise for improved outcomes and reduced toxic effects in the future.
伯基特淋巴瘤是一种高度侵袭性的 B 细胞非霍奇金淋巴瘤,也是人类生长最快的肿瘤。该疾病与 Epstein-Barr 病毒有关,是最早被发现具有染色体易位激活致癌基因(c-MYC)的肿瘤之一。伯基特淋巴瘤是疟疾流行地区儿童中最常见的癌症。在非流行地区的免疫抑制患者中发病率非常高,特别是与 HIV 感染相关时。强化化疗的疗效有所改善,目前在儿童中疗效极佳,但在老年患者中预后较差。强化治疗的成功依赖于良好的支持性护理。低收入国家肿瘤病房提供的治疗不如高收入国家中心那样积极,治疗效果也较差。未来,用利妥昔单抗进行辅助单克隆抗体治疗有望改善疗效并降低毒性作用。