American Board of Internal Medicine (ABIM) Certification Practice Exam

What therapy is required for patients with Burkitt lymphoma?

1. Combination chemotherapy

2. Radiation therapy

3. Observation only

4. Single-agent chemotherapy

The correct answer is: Combination chemotherapy

For patients with Burkitt lymphoma, combination chemotherapy is the required therapy due to the aggressive nature of this type of non-Hodgkin lymphoma. Burkitt lymphoma is characterized by rapid cell proliferation and a high growth rate, necessitating a treatment approach that can effectively target and eliminate a large population of malignant cells quickly. Combination chemotherapy regimens, such as those that include agents like cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or more intensive regimens like dose-adjusted EPOCH-R, have been shown to improve outcomes significantly. The use of multiple drugs works to maximize the likelihood of tumor cell kill by employing different mechanisms of action, reducing the risk of drug resistance, and enhancing overall treatment efficacy. In contrast, radiation therapy, while sometimes employed, is not the primary treatment modality for Burkitt lymphoma, especially in cases where systemic disease is present. Observation alone is inappropriate, given the aggressive progression of the disease without prompt treatment. Single-agent chemotherapy lacks the necessary intensity and breadth needed to manage this rapidly growing lymphoma effectively. Thus, the most effective and appropriate approach remains the use of combination chemotherapy.