Burkitt Lymphoma (BL)

"Genetic Subgroups Inform on Pathobiology in Adult and Pediatric Burkitt Lymphoma"

Burkitt lymphoma is a rare but aggressive type of non-Hodgkin lymphoma that affects people of all ages, though it's more common in children and young adults. It's linked to abnormalities in white blood cells and is characterized by fast-growing tumors in the lymphatic system.

The impact of Burkitt lymphoma (BL) is far-reaching, not only affecting individuals diagnosed but also their families and communities. Its symptoms can be severe and include rapid swelling of lymph nodes, fever, night sweats, and weight loss. Prompt diagnosis and treatment are crucial for the best outcomes, often involving chemotherapy, immunotherapy, and sometimes radiation therapy.

In 2023, the FDA approved onartuzumab veduta (POLARIZEM) for the treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), not otherwise specified, including Burkitt lymphoma. POLARIZEM is a monoclonal antibody that targets CD79b, a protein found on the surface of B cells.

Burkitt's lymphoma frequently begins in internal organs such as the spleen and abdomen. Children are usually affected by this illness, whereas younger adults are affected less commonly. Burkitt's lymphoma is sometimes lethal. Burkitt's lymphoma disease affects jaw and facial bone, central nervous system, ovaries, bowel, kidneys, and other organs.

According to a survey conducted by Cancer Therapy Advisor, 30% of pediatric lymphomas and less than 1% of adult lymphoma cases worldwide are due to Burkitt lymphoma in children and individuals with compromised immune systems.

The most common symptom of Burkitt lymphoma is having swollen lymph nodes in the neck, armpit, or groin. This can be a rapid weight loss of 10% or more of your body weight over a few months. If lymphoma affects bone marrow, which might not have enough blood cells, it can cause weakness, extreme tiredness (fatigue), a higher risk of infection, higher risk of bleeding.

Identifying BL early is crucial for successful treatment. Recent developments in molecular diagnostics like FISH (Fluorescence in-situ Hybridization) and PCR (polymerase chain reaction) have enhanced the accuracy and speed of diagnosis, allowing for earlier intervention.

Furthermore, treatment using chemotherapy remains the mainstay of BL treatment, with intensive regimens achieving high cure rates (up to 80% in some cases). However, these regimens are associated with significant side effects.

Burkitt's lymphoma affects people living with HIV/AIDS and children in Africa between the ages of 4 and 7. The World Health Organization classifies the disease into endemic, sporadic, and immunodeficiency-associated forms.

Increased awareness of Burkitt lymphoma, better government support for the disease, and government approval of innovative therapies are all expected to drive growth in this market.

In the endemic form of Burkitt lymphoma, which is more common in Africa, swelling of the jaw or other facial bones is a characteristic symptom. The distribution of endemic cases of BL in Africa and Papua New Guinea corresponds to areas where the Epstein-Barr virus and malaria are prevalent. In children under 18, the incidence is about 3 to 6 cases per 100,000 children annually. Six years old is the typical diagnostic age.

The sporadic form, which is limited to most lymphoma types in North America, is more common in men with a male-to-female ratio of 3–4:1 and in Europe, where the median age of diagnosis is 45. The estimated yearly incidence of sporadic BL is 4 per 1 million in children under 16 and 2.5 per 1 million in adults. Pediatric patients often receive their diagnoses between the ages of 3 and 12. In the US, the incidence of immunodeficiency-associated variation is 22 per 100,000 people.

Although traditional treatment platforms for this disease less toxic approaches that preserve the high cure rates of rigorous standard therapies have lately been devised, even though established therapy platforms for this disease are highly toxic. The best course of action for adults with Burkitt's lymphoma is still up for debate.

The common risk factors for Burkitt lymphoma include age, sex, viral infection, malaria, weak immune system, Epstein-Barr virus, and other factors that have an impact on the genetic makeup of the cells. All the above risk factors cause serious complications. In-depth research is required to treat Lymphoma and reduce the risk of getting Lymphoma.

Currently, early detection of lymphoma is essential. The development of therapeutic medicines with lower costs and fewer side effects is critical in the context of lymphoma. Market players have several opportunities to engage in this sector and raise the value of their business.

DiseaseLandscape Insights facilitates informed decision-making in the fields of medical technology, medicines, and diagnostics as innovative advancements and cutting-edge technologies alter the landscape and promote more growth.

Diagnosis Analysis -

The diagnosis of Burkitt lymphoma is based on the type of lymphoma, signs and symptoms of patients, medical history of patients, physical evaluation, age, gender, and interpretation of previous test results. The following diagnostic techniques are performed to diagnose non-Hodgkin lymphoma (NHL).

A relative survival rate contrasts individuals with non-Hodgkin lymphoma (NHL) of the same kind and stage with those in the general population. For instance, if a certain stage of NHL has a 5-year relative survival rate of 70%, it indicates that the chances of a person with that cancer living for at least five years following diagnosis are, on average, around 70% higher than those without it.

Bone Marrow Aspiration and Biopsy –

A PET scan employs a small quantity of radioactive material, which assists in identifying cancer cells throughout the body that may not be seen on a CT scan, and helps evaluate whether a lymph node that has expanded is malignant. After starting medication, some lymphoma patients have PET scans to see if their malignancy is responding to the treatment. When paired with an MRI or CT scan, a PET scan yields very detailed pictures of the body.

Imaging Test -

1. Magnetic Resonance Imaging (MRI) –

According to NCBI, Magnetic Resonance Imaging (MRI), although not usually used in the emergency context, is becoming more and more important in the assessment of BL. One of MRI's strongest points is its exceptional soft tissue characterization, which comes in handy for determining whether a tumor has spread to the central nervous system (CNS).

Although methods should be customized to the anatomy being studied, standard protocols use a combination of multiplanar T1- and T2-weighted images, with and without fat saturation. For example, Magnetic Resonance Cholangiopancreatography (MRCP) can be performed if biliary blockage is a clinical issue. Diffusion-weighted imaging (DWI) has shown added benefit over traditional sequences by boosting the accuracy of first diagnosis in other lymphoma subtypes and increasing lesion conspicuity, despite the paucity of evidence specifically related to Burkitt lymphoma.

2. Blood Test –

According to DLI analysis, blood samples are tested in a lab. If lymphoma spreads to the bone marrow, the quantity of white blood cells, platelets, and red blood cells may decrease. Blood tests to check your blood cell counts and test how well your liver and kidneys are working.

3. Ultrasound –

According to NCBI, studies report varying sensitivity for ultrasound in detecting Burkitt lymphoma, ranging from 65% to 90%. This means that while it can reliably detect some cases, it may miss others. Ultrasound has higher specificity, meaning it can accurately distinguish lymphoma from other conditions in most cases. However, other types of lymphoma can also appear similar on ultrasound. Ultrasound scans help examine specific organs, like the kidneys and liver, and highlight any changes. High-frequency sound waves are used in ultrasound scans to provide an image of a body part.

4. Positron Emission Tomography (PET) –

According to NCBI, Positron emission tomography (PET), which uses a radioactive intravenous drug to identify areas of high chemical or metabolic activity, shows enhancement of the abdominal mass and of multiple nerve roots. PET/CT for initial staging may be helpful, although it is not now generally advised. Nevertheless, it shouldn't wait to begin therapy. The need for contrast-enhanced neck and/or brain MRI may also arise based on the clinical presentation. Before therapeutic completion, the role of PET/CT imaging is not well defined. Studies examining this method in BL have not yielded similar findings as those proving the predictive benefit of interim PET/CT in DLBCL. PET/CT is advised as the preferred modality if relapsed or resistant illness is a concern.

5. Chest X-Ray –

According to DLI analysis, check for swollen lymph nodes, and a chest x-ray is performed. This shows the heart, lungs, and other parts of the chest. 

6. Bone Scan –

According to NCBI bone scans alone are not very sensitive for detecting Burkitt lymphoma in bones. Acccording to NIH Bone scans have moderate specificity (70-80%) and sensitivity (50-70%) for detecting bone marrow infiltration in Burkitt lymphoma. Positive bone scan rate estimates vary, but 30-50% of patients with Burkitt lymphoma exhibit bone marrow involvement detectable on bone scans.

Market Competitors

Below are the names of market competitors who are transforming healthcare with their advanced diagnostic approaches and their products are listed below.

Burkitt Lymphoma Treatment Analysis-

There are various treatment options available based on the type of lymphoma, stage of the lymphoma, age of the patient and overall health of the patient, the history of the patient, and previous results of the tests. The following techniques and therapies are used for the treatment of lymphoma.

1. Chemotherapy -

One of the major treatments for lymphoma is chemotherapy, which can be administered either alone or in conjunction with radiation therapy. It entails the injection or oral administration of medications that destroy cancer. Chemotherapy is administered into the spinal column using a lumbar puncture in CNS prophylaxis, which is used to treat non-Hodgkin lymphoma patients who have progressed to the brain or are at high risk of doing so. Steroid medications can also be used to reduce inflammation and edema.

2. Radiation Therapy –

Using high-energy radiation therapy reduces tumor size and eliminates cancer cells. External beam therapy is a treatment option for patients with lymphoma that involves directing high-energy X-ray beams at the tumor and malignant lymph nodes from outside the patient using a machine. Chemotherapy can be administered in addition to or instead of external beam treatment.

3. Monoclonal Antibody Therapy (also called Targeted Therapy) -

Monoclonal antibodies, which are manufactured in laboratories and designed to identify and bind to the surface of cancer cells, are used in this treatment. Monoclonal antibodies are synthetic versions of the naturally occurring antibodies in the body that fight off external invaders like bacteria and viruses. Combining monoclonal antibodies with radioactive material or chemotherapeutic medication enables the antibody to directly provide a dosage of the cancer-killing substance to the cancer cell.

Two common monoclonal antibodies used for Lymphoma are:

1) Rituximab – A monoclonal antibody designed to seek out and lock onto the protein receptor (CD20) found on a specific type of lymphocyte (B cells), which causes the lymphoma cell to die. This treatment is used for many patients with "B-cell" lymphoma and may be combined with chemotherapy and radiation therapy.

Rituximab's targeted attack on CD20, leading to B-cell depletion and activation of immune effector mechanisms, makes it a highly effective weapon against Burkitt lymphoma. However, it's important to note that resistance to rituximab can develop, and treatment success depends on various factors. Human peripheral blood mononuclear cells generate ADCC of human lymphoma cell lines with Rituximab.

2) Brentuximab Vendition (Acetis) – Brentuximab Vendition combines a chemotherapy drug with a monoclonal antibody that attaches to a specific molecule (CD30) on the surface of Hodgkin disease cells and some other types of lymphoma.

4. Radioimmunotherapy (also called radiolabeled monoclonal antibody therapy)-

Radioimmunotherapy pairs a monoclonal antibody with a radioactive material, such as Yttrium-90 with Ibritumomab Tiuxetan (Zevalin®). The radiolabeled monoclonal antibody travels to and binds to cancer cells, allowing high doses of radiation to be delivered directly to the tumor cells.

5. Biologic Therapy –

Biologic Therapy treatment involves natural, or laboratory substances designed to boost, direct or restore the body’s natural defenses against cancer, or to interfere with specific biologic pathways within the lymphoma cells. One kind of biological therapy that slows the development of tumors and interferes with the way cancer cells divide is called interferon. Agents that disrupt the lymphoma cells' metabolic processes include ibrutinib and lenalidomide.

Stem cell transplant: To encourage the growth of new bone marrow, damaged bone marrow is replaced with either the patient's healthy stem cells (autologous) or donor stem cells (allogeneic). If lymphoma recurs following therapy, a stem cell transplant could be necessary. Before receiving a stem cell transplant, patients first endure high-dose chemotherapy and whole-body external beam radiation to eradicate as many lymphoma cells as possible from their bodies.

Overall, the Burkitt lymphoma treatment market presents significant opportunities for innovation, collaboration, and improved patient care. By addressing the challenges and capitalizing on these opportunities, stakeholders contribute to making effective and accessible treatments a reality for all patients with this aggressive disease.

Market research and consulting services of DiseaseLandscape Insights assist key players to stay upright in the treatment field of lymphoma. DLI provides comprehensive assistance with planning, carrying out, and analyzing clinical trials for the development of novel drugs.

Treatment Key Players –

Regulatory Framework-

DiseaseLandscape Insights aggregates burkitt lymphoma regulatory standards from many countries. DLI provides empirical data on regulatory compliance, risk assessment, and monitoring. By investigating the DLI services, organizations and market actors may prevent, manage, and respond to flare-ups of skin cancer and ensure the safety of afflicted individuals.

However, the FDA granted rapid approval to Mosunetuzumab-axgb (Lunsumio) on December 22, 2022, for adult patients with relapsed or refractory follicular lymphoma resulting from two or more lines of systemic treatment.

Moreover, Glofitamab-gxbm has received accelerated approval by the FDA for a subset of relapsed or refractory large B-cell lymphomas. The Food and Drug Administration gave glofitamab-gxbm a rapid approval on June 15, 2023.

Overall, regulatory rules have a considerable influence on the Lymphoma sector, and DLI offers an in-depth evaluation of several regional standards that are now in place, as well as prospective future changes in the Lymphoma illness market.

Competitive Analysis –

The key players participating in the global Burkitt lymphoma treatment market are Novartis AG, Sanofi Pasteur, Eisai Inc., Cellerant Therapeutics, Inc., Pfizer, Inc., Merck KGaA, Seattle Genetics, Inc., Boehringer Ingelheim GmbH, AbbVie Inc., and Karyopharm Therapeutics, Inc. are businesses that provide a range of efficacious medications to address the growing unmet requirements of patients with relapsed or refractory Burkitt lymphoma. For example, in 2015, Servier and Pfizer Inc. started Phase I research for gene-edited allogeneic CAR19 T-cells (UCART19) to treat pediatric patients with relapsed or refractory acute lymphoblastic leukemia (ALL).

In November 2023, Xencor announced positive Phase II data for XENP1346, showing a high complete response rate and favorable safety profile in patients with relapsed/refractory Burkitt lymphoma.

There are many different market participants operating both globally and regionally within the highly fragmented global market. Each market participant is thoroughly examined in the study, along with their plans for product releases, worldwide positioning, corporate expansion strategies, and research and development expenditures. In addition, the industry participants are preparing several strategic partnerships to maintain their market share and expand their range of offerings.

The study has identified market leaders, rivals, and niche businesses by comprehensive research, accounting for a range of variables like market share, product portfolios, and current industry dynamics. Businesses may improve their comprehension of competitive situations and make informed judgments about their market strategy by evaluating this data.

Market Trends –

The Burkitt lymphoma market is a rapidly growing market with a lot of potential. The development of new therapies, the increasing use of immunotherapy and targeted therapies, and the growing importance of early diagnosis are all expected to contribute to the market's growth in the coming years.

The rise of immunotherapy: Immunotherapy is a type of cancer treatment that helps the body's immune system to fight cancer cells. Immunotherapy drugs have shown promise in the treatment of Burkitt lymphoma, and they are expected to play an increasingly important role in the future.

The use of targeted therapies: Targeted therapies are drugs that are designed to attack specific genetic mutations in cancer cells. There are several targeted therapies in development for Burkitt lymphoma, and they have the potential to revolutionize the treatment of this disease.

The growing importance of early diagnosis: Early diagnosis is essential for the successful treatment of Burkitt lymphoma. There is a growing focus on developing new diagnostic tools and techniques that can help to detect the disease at an early stage.

The increasing role of precision medicine: Precision medicine is a type of medicine that considers the individual genetic makeup of a patient's tumor to determine the best course of treatment. Precision medicine is expected to play an increasingly important role in the treatment of Burkitt lymphoma in the future.

Development of new treatments: There have been significant advances in the treatment of Burkitt lymphoma in recent years. New drugs and therapies are being developed that are more effective and have fewer side effects than traditional treatments.

Clinical Trial Data Assessment –

DiseaseLandscape Insights continues the exciting journey into the field of Burkitt lymphoma treatment, where remarkable innovative opportunities and novel developments will change the way diseases are treated. DiseaseLandscape Insights makes it easy to establish and implement clinical trials for novel treatments and drugs, patient recruitment tactics, regulatory compliance, and assuring favorable trial outcomes. These are all made easier with the assistance of DiseaseLandscape Insights.

The table below includes the study names of the ongoing clinical trials as well as the stages at which they are taking place.

Conclusion –

Understanding the dynamics of illness is crucial, according to DiseaseLandscape Insights (DLI), particularly in the context of the burkitt lymphoma disease sector. With the aid of DLI's extensive offerings, the healthcare industry, its experts, researchers, and other industry players want to enhance patient outcomes while fortifying and growing their own enterprises.

As with any medical condition, the specific outlook can vary depending on various factors such as the stage at diagnosis, overall health, and how the individual responds to treatment. Regular follow-ups after successful treatment are essential to monitor for any signs of recurrence and ensure ongoing health.

Remember, while Burkitt lymphoma can be a serious condition, advancements in medical science have significantly improved treatment outcomes, offering hope and a good chance for recovery.

This enables market leaders to conduct focused research and development, find sources of raw materials, research contract manufacturing companies, and ensure legal compliance for the company. All in all, DLI assists market players to stay strong and helps to grow the continuous Burkitt lymphoma field.