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Burkitt lymphoma high-risk features: HIV+ AND CD4 <100 OR ECOG ≥3 OR LDH >3× ULN OR CNS i...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDRF-BURKITT-HIGH-RISK
TypeRed flag
Statusreviewed 2026-04-25 | pending_clinical_signoff
DiseasesDIS-BURKITT
SourcesSRC-ESMO-BURKITT-2024 SRC-NCCN-BCELL-2025

Red Flag Origin

DefinitionBurkitt lymphoma high-risk features: HIV+ AND CD4 <100 OR ECOG ≥3 OR LDH >3× ULN OR CNS involvement OR bulky abdominal disease — selects more intensive CODOX-M/IVAC over DA-EPOCH-R
Clinical directionintensify
Categoryhigh-risk-biology
Shifts algorithmALGO-BURKITT-1L

Trigger Logic

{
  "any_of": [
    {
      "finding": "burkitt_high_risk",
      "value": true
    },
    {
      "finding": "cns_involvement",
      "value": true
    },
    {
      "finding": "ldh_above_3x_uln",
      "value": true
    },
    {
      "finding": "leukemic_phase",
      "value": true
    },
    {
      "finding": "bulky_abdominal",
      "value": true
    }
  ],
  "type": "composite_clinical"
}

Notes

CALGB 10002 / CALGB 50202 evidence that DA-EPOCH-R is sufficient for most adult Burkitt INCLUDING HIV-associated, but high-risk features push to CODOX-M/IVAC (Magrath) or hyper-CVAD/MA. CNS involvement is mandatory CODOX-M/IVAC (HD-MTX dose-intense regimen).

Used By

Algorithms

Indications