Burkitt lymphoma treatment and side effects

• The aim of treatment for most people is to put you into remission (where there is no sign of the lymphoma left) with the hope of a cure.
• Treatment for Burkitt lymphoma includes a combination of chemotherapy and immunotherapy.
• If Burkitt lymphoma comes back (relapse), different types of treatment may be given.
• Treatment can cause side effects, but your hospital team can help.

A team of specialists will meet to discuss the best treatment for you. They are called a multidisciplinary team (MDT). They will discuss treatment options with you and things to consider.

They will recommend treatment based on factors such as:

• the stage of Burkitt lymphoma
• whether you have high risk or low risk lymphoma
• your general health and fitness
• possible side effects and late effects
• your preferences.

If you have any questions or concerns about your treatment options, don’t be afraid to ask your team. We have information about treatment planning and your team.

The most common treatments for Burkitt lymphoma are:

• chemotherapy with or without steroids. This may be given as a main treatment or to help you get well enough for more intensive treatment
• intensive chemotherapy combined with immunotherapy using a targeted cancer drug such as rituximab. This is called chemo-immunotherapy
• chemotherapy to stop lymphoma spreading to your brain and spinal cord.

There are different chemotherapy combinations. Your hospital team will recommend the best treatment for you.

If you have low-risk Burkitt lymphoma, or if you cannot tolerate intensive chemotherapy, you might have several cycles of a less intensive treatment called R-CHOP (rituximab, cyclophosphamide, doxorubicin, hydrochloride, vincristine and prednisolone).

If you have high risk Burkitt lymphoma and you are fit enough, you are likely to be treated with one of the following regimens:

• R-CODOX-M/R-IVAC: rituximab plus cyclophosphamide, vincristine (Oncovin), doxorubicin and methotrexate or rituximab plus ifosfamide, etoposide (VP-16) and cytarabine (Ara-C). Two alternating cycles of each regimen is given to give four treatment cycles in total.
• DA-EPOCH-R: dose-adjusted etoposide, prednisolone, vincristine (also known as Oncovin), cyclophosphamide and doxorubicin (or hydroxydaunorubicin) plus rituximab. Six cycles of treatment are usually given for high-risk disease.

We have information about chemotherapy and immunotherapy.

Treatment may last several months and usually involves staying in a hospital for several weeks. In some cases, depending on your treatment type, you may be able to have some of it at home. You will usually have several cycles of treatment, with more cycles if you have high risk Burkitt lymphoma.

Side effects are the unwanted effects of blood cancer treatment. Many of the side effects can be treated or prevented.

Side effects can include:

• sickness and vomiting
• hair loss
• increased risk of infections
• fatigue.

We have more information about some of the possible side effects of blood cancer treatment.

Side effects of rituximab which is used in chemo-immunotherapy can include:

• fever
• night sweats
• an itchy rash
• chills
• shivering.

It is important to let your hospital team know as soon as you get any side effects. They can give you medicines to help prevent or lessen the side effects.

Chemotherapy and other blood cancer treatments can affect people in other ways such as the ability to have children (fertility). If you wish to have children, you can ask about the fertility options available to you before you start chemotherapy.

We also have more information about the late effects after blood cancer treatment.

Tumour lysis happens when the balance of chemicals in your blood suddenly changes. This can be caused by treatment for the lymphoma or by the lymphoma itself. Chemotherapy can kill a lot of lymphoma cells very quickly. The cells release chemicals as they break down. Your body may not be able to get rid of the extra chemicals quickly. This is called tumour lysis syndrome. It can cause serious problems with your kidneys and your heart.

You will have regular blood tests to check for tumour lysis if your risk of developing it is high. Your hospital team will give you medicines such as a tablet or drip to help prevent it. This is called supportive care. Drinking plenty of fluids may help lower your risk of getting tumour lysis.

Your hospital team will also monitor you closely for infections if you’re in hospital. They will advise you on what to look out for and what to do if you are an outpatient.

Supportive care can help prevent or manage problems caused by lymphoma and its treatments. Other supportive treatments you may have include medicines to prevent infections and to boost your immune system.

You will have a scan at the end of treatment to see how you have responded to treatment. This is usually a PET scan or a CT scan. You may also have other tests. The results of these can help your specialist to see if you’re in remission (disappearance or significant shrinkage of the lymphoma).

You will have regular follow-up appointments after this. This will usually be every three months to begin with. Your doctor will examine you and ask about any symptoms or side effects. If you have any questions or concerns, you can also contact your hospital team. You don’t have to wait for an appointment.

Many hospital teams offer follow-up appointments or give you the option to book appointments when you need them. This is usually for at least a year after you finish treatment.

At the end of your treatment, your hospital team will discuss the treatment you have had with you. They will also give you a written summary of this and send a copy to your GP.

Burkitt lymphoma may come back after treatment was initially successful, this is called a relapse. In some people, Burkitt lymphoma may not respond to treatment and may not go into remission. This is called refractory lymphoma. If it happens, relapse will usually occur within one year of finishing your first treatment.

While relapsed or refractory lymphoma can be hard to treat, there are options. You may have one or a combination of some of the treatments you had before such as:

• chemotherapy – using different drugs
• immunotherapy – using different drugs.

You may also have other treatments such as:

• a stem cell transplant – this involves replacing the stem cells in your body with new, healthy stem cells. These can be your own (autologous) or a donor’s (allogenic) stem cells. This is usually given after high-dose chemotherapy if you are well enough for it
• CAR T-cell therapy – this is a relatively new treatment which is given if you haven’t responded to initial treatment. You may need to meet certain conditions to get it
• radiotherapy.

Your hospital team may also talk to you about taking part in a clinical trial. You can use our Clinical Trials Support Service for support and information.

Your hospital team will talk to you about symptoms to look out for. Let them know as soon as you get any symptoms of a relapse.

This information is accredited with the PIF TICK, the UK's only quality mark for trusted health information.

Last review January 2026. Next full review due January 2029. We may make factual updates to the information between reviews.

Thank you to Consultant Haematologist Samuel Harrison for checking the clinical accuracy of our Burkitt lymphoma information.