Good prognostic indicators are a high CD4 count, absence of progression to AIDS, absence of extranodal disease, polyclonality, the absence of bone marrow involvement, age less than 35 years, and a nonimmunoblastic subtype. Virtually all of Burkitt's lymphomas associated with AIDS exhibit c-myc gene rearrangement. Additionally, many exhibit p53 mutations, less than half contain EBV and none exhibit bcl-6 gene rearrangements. Most of these patients present with wide dissemination and bone marrow involvement. B symptoms are typically present in this population of patients.
Death usually occurs shortly after diagnosis.
Systemic chemotherapy can be used, however, most of these patients tolerate it poorly due to their underlying immune deficiency and leukopenia. The histology of endemic and sporadic Burkitt's lymphoma is indistinguishable. The tumor grows as an expansile nodule that compresses the surrounding tissue. Reactive histiocytes are scattered throughout the neoplasm. This pattern is not specific to Burkitt's lymphoma, although it is almost always present in this neoplasm.