Publication

Diagnosis of Burkitt lymphoma in due time: a practical approach

Journal Paper/Review - Aug 1, 2006

Units
PubMed
Doi

Citation
Cogliatti S, Novak U, Henz S, Schmid U, Möller P, Barth T, Swiss Group for Clinical Cancer Research (SAKK). Diagnosis of Burkitt lymphoma in due time: a practical approach. British journal of haematology 2006; 134:294-301.
Type
Journal Paper/Review (English)
Journal
British journal of haematology 2006; 134
Publication Date
Aug 1, 2006
Issn Print
0007-1048
Pages
294-301
Brief description/objective

The quick diagnosis of Burkitt lymphoma (BL) and its clear-cut differentiation from diffuse large B-cell lymphoma (DLBCL) is of great clinical importance because treatment strategies for these two disease entities differ markedly. As these two lymphomas are difficult to distinguish using the current World Health Organization classification, we studied 39 cases of highly proliferative peripheral blastic B-cell lymphoma (HPBCL) to establish a practical differential-diagnostic algorithm. Characteristics set for BL were a typical morphology, a mature B-cell phenotype of CD10+, Bcl-6+ and Bcl-2- tumour cells, a proliferation rate of >95%, and the presence of C-MYC rearrangements in the absence of t(14;18)(q32;q21). Altogether, these characteristics were found in only five of 39 cases, whereas the majority of tumours revealed mosaic features. We then followed a pragmatic stepwise approach for a classification algorithm that included the assessment of C-MYC status to stratify HPBCL into four predefined diagnostic categories (DC), namely DC I (5/39, 12.8%): 'classical BL', DC II (11/39, 28.2%): 'atypical BL', DC III (9/39, 23.1%): 'C-MYC+ DLBCL' and DC IV (14/39, 35.9%): 'C-MYC- HPBCL'. This proposal may serve as a robust and objective operational basis for therapeutic decisions for HPBCL within 1 week and is applicable to be evaluated for its prognostic relevance in clinical trials with uniformly treated patients.