The next step for Burkitt lymphoma

which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The successes in the treatment of childhood acute lympho-blastic leukemia (ALL) are well known, with a cure rate of more than 80% of patients treated. However, for the minority of patients who fail to achieve long-term remission, treatment options are limited with overall poor prognosis. Much the same can be said for Burkitt lymphoma today, once considered in the same disease category as precursor B ALL and erroneously treated in a similar manner. The major characteristics of Burkitt lymphoma are well established; morphologically, Burkitt lymphoma consists of a homogenous population of medium-sized cells with a high mitotic rate [1]. Immunophenotype spectrum includes ex-and negative results for TdT [2]. Above all, important corroborating evidence for the diagnosis of Burkitt lymphoma includes translocations involving the MYC gene at locus 8q24. These MYC translocations consist of t(8;14)(q24;q32), by far the most common, and t(8;22)(q24;q11) and t(2;8) (p12;p24) to a much lesser extent, all of which result in the realignment of the MYC oncogene with immunoglo-bulin promoter/enhancer elements. Tumor lysis syndrome is an important complication that requires meticulous attention during the early phases of treatment. All of these traits also apply to ALL, L3 and the two entities are now considered to represent different aspects of the same disease. In the early 1980's, it became known that short, intensive treatment of childhood Burkitt lymphoma, rather than a protracted treatment course, as is commonly administered to patients with precursor B ALL, is highly effective [3]. Under this tenet, multi-center studies including the LMB and BFM studies have contributed significantly to improve the outcome of children with Burkitt lymphoma. Relying on agents such as cyclophosphamide, methotrexate, and cytarabine, and central nervous system (CNS)-directed therapy , these studies have been crucial in elevating the previously dismal survival of the patients to 80% to 90% range. Initial successes in the pediatric population have also had a positive influence on the treatment of adults with Burkitt lymphoma, resulting in major advances in outcome for these patients as well. In this issue of the Korean Journal of Hematology, Park et al. report the outcomes of children with Burkitt lympho-ma/leukemia treated within a single institution in Korea in a long period spanning from 1991 to 2007 [4]. Major conclusions from their study include observations on improved survival of patients treated with the LMB96 …