Burkitt lymphoma (BL) may be defined as an aggressive rare disorder
that constitutes approximately 1% to 2% of all non-Hodgkin lymphomas.
Burkitt lymphoma is known as one of the most aggressive forms of
lymphoma, with a doubling time of approximately 24 hours. The term
was coined after an Irish surgeon named Denis Burkitt, who first
described the lymphoma in 1958, and was the first to successfully
compile description of significant number of cases with the disorder.
A range of intensive therapy regimen is available to choose from
which depends upon local practice. The CODOX-M/IVAC is the most
commonly administered regimen, first introduced as pediatric regimen
in 1980 by Magrath et.al. Various regimen for Burkitt lymphoma (BL)
are R-CODOX-M/IVAC regimen, BFM/GMALL/NHL regimen, Hyper-CVAD
regimen, CALGB and LMB regimen, DA-EPOCH-R regimen, and other
high-intensive regimens. Burkitt lymphoma is represented by three
clinical sub-types: endemic Burkitt lymphoma (eBL),
immunodeficiency-associated Burkitt lymphoma (iBL), and sporadic
(sBL).
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These clinical sub-types share similar morphological and
immunophenotypic features, while conform largely with respect to
genetic makeup, and differ in exhibiting few clinical features as
well as incidence pattern. Sporadic Burkitt lymphoma (sBL) is a rare
disorder generally affecting all age groups. It accounts for
approximately 1% of adult lymphomas and reported in areas lacking
endemic malaria. Endemic Burkitt lymphoma (eBL) is predominantly a
pediatric disease or disorder, accounting for about 30% to 50% of
pediatric cancer in regions with holoendemic malaria. Endemic Burkitt
lymphoma (eBL) clinically differs by affecting facial bones
especially the jaw. Immunodeficiency-associated Burkitt lymphoma
(iBL) accounts for 10% to 40% of all HIV (Human Immunodeficiency
Virus) associated lymphomas and was the first to be recognized in HIV
setting.
The CODOX-M/IVAC regimen includes cytarabine, cyclophosphamide,
doxorubicin, etoposide, high-dose cytarabine, IT methotrexate,
leucovorin, vincristine/ifosfamide. BFM/GMALL/NHL regimen generally
consists of pre-phase treatment with prednisone and cyclophosphamide,
which is then commenced by alternating chemotherapy with six cycles
including doxorubicin, dexamethasone, ifosfamide, high-dose
methotrexate, teniposide, cytarabine, and vincristine. It also
includes triple IT therapy with cytarabine, dexamethasone, and
methotrexate. Hyper-CVAD regimen which was initially developed for
acute lymphoblastic leukemia includes four cycles of
hyperfractionated cyclophosphamide, dexamethasone, vincristine, and
doxorubicin.
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CALGB and LMB regimens utilize prednisone and cyclophosphamide as a
pre-phase cycle, followed by alternating chemotherapy cycles
depending upon the risk. DA-EPOCH-R regimen consists of different
approach with low concentration chemotherapy agents being exposed for
long period of time as compared to that of other high-intensive
regimen, comprising infusional EPOCH (cyclophosphamide, etoposide,
doxorubicin, vincristine, and prednisone). This regimen is
specifically used in order to provide continuous exposure of
cytotoxic agents to tumor cells and to bring about decrease in
toxicity. Many variations of short-cycle, high intensive regimens are
being developed and used in addition to these regimens.
The global Burkitt lymphoma (BL) therapeutics market can be segmented
based on clinical type, drug therapy regimen, distribution channel,
and region. In terms of clinical type, the market can be classified
into endemic BL (eBL), immunodeficiency-associated BL (idBL), and
sporadic variant (sBL). Based on drug therapy regimen, the global
Burkitt lymphoma (BL) therapeutics market can be categorized into
R-CODOX-M/IVAC regimen, BFM/GMALL/NHL regimen, Hyper-CVAD regimen,
CALGB and LMB regimen, DA-EPOCH-R, and other high-intensive regimens.
In terms of distribution channel, the market can be divided into drug
stores, hospital pharmacy, online pharmacy, retail pharmacy, and
others.
In terms of region, the global Burkitt lymphoma (BL) therapeutics
market can be segmented into Asia Pacific, Europe, Middle East &
Africa, North America, and Latin America.
Key players in the global Burkitt lymphoma (BL) therapeutics market
are Bedford Laboratories, Sun Pharma, Seattle Genetics, Inc., Sanofi,
Mayo Clinic, Pfizer, Inc., Merck KGaA, and Cellerant Therapeutics,
Inc., among others.
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