--- title: 5-Year-Old with High-Risk Burkitt Lymphoma Achieves Complete Remission with Chemotherapy and Targeted Immunotherapy url: "https://www.yyhmedical.com/en/stories/burkitt-lymphoma-targeted-immunotherapy" type: Article inLanguage: en-US disease: Burkitt Lymphoma treatment: Chemotherapy, Targeted therapy datePublished: 2026-06-12 --- # 5-Year-Old with High-Risk Burkitt Lymphoma Achieves Complete Remission with Chemotherapy and Targeted Immunotherapy > After multiple rounds of chemotherapy failed to achieve complete remission, a fresh assessment and personalized combination treatment opened up a new path forward. Summary: Five-year-old Dingding (pseudonym) was diagnosed with high-risk stage III Burkitt lymphoma after developing a persistent fever. Genetic testing identified several tumor-related abnormalities, including TP53, MYC, ID3, and GNA13. He received multiple courses of first- and second-line chemotherapy at another hospital. Although the lesions became smaller, he did not achieve complete remission. In January 2026, Dingding was transferred to the Department of Pediatric Hematology & Oncology at Beijing GoBroad Boren Hospital. Prof. Yonghong Zhang's team repeated the pathology and imaging review and completed additional target-expression testing. Based on his previous response to treatment and strong CD79b expression, the team developed a personalized regimen combining chemotherapy with targeted immunotherapy. After several courses of treatment and consolidation therapy, Dingding achieved complete remission and has continued to maintain it. He is now steadily recovering and looking forward to returning to school. His experience shows how comprehensive reassessment and individualized combination therapy can create new possibilities for children with high-risk Burkitt lymphoma when multiple rounds of chemotherapy have not achieved remission. In October 2025, five-year-old Dingding (pseudonym) was diagnosed with high-risk stage III Burkitt lymphoma after seeking care for a persistent low-grade fever. Genetic testing showed a TP53 mutation as well as abnormalities involving MYC, ID3, GNA13, and other tumor-related genes. After four courses of chemotherapy at a hospital in Tianjin, he still had not achieved complete remission. His family refused to give up. In January 2026, his parents brought him to Beijing GoBroad Boren Hospital to see pediatric hematology-oncology specialist Prof. Yonghong Zhang. Soon after admission, Prof. Zhang and her team carried out a new pathology review and developed a risk-adapted, individualized plan combining chemotherapy with targeted immunotherapy. After just over three months of structured treatment, Dingding achieved complete remission (CR) and was discharged to continue his recovery at home. Today, he is getting stronger day by day and looking forward to the moment he can return to school. ![9be106c9-fce5-4b05-b105-a24d039058e7.png](https://gaobo-byh-h5.oss-accelerate.aliyuncs.com/images/20260912/d3ba1fbaf3c4eb890844e2c5c9a4ee30_20260912212404.png "d3ba1fbaf3c4eb890844e2c5c9a4ee30_20260912212404.png") Group photo at discharge **Persistent Fever Leads to a Diagnosis of High-Risk Lymphoma at Age Five** Before Dingding became ill, our family life was calm and ordinary. Then, on the evening of September 25, 2025, he suddenly developed a fever of 39.4°C. The fever came down after medicine, but for more than a week afterward he kept running a low-grade fever during the day that would settle at night. On October 4, we took him to our county hospital. Based on his blood test and chest X-ray, the doctor initially thought it was pneumonia. But after three days of IV treatment, he was no better at all. I kept thinking, if this really is pneumonia, why is the treatment not helping? I did not want to wait any longer, so that same day I decided to take him to a major hospital in Tianjin. That afternoon, Dingding had an ultrasound, blood tests, and other examinations. The results came back quickly. His attending doctor did not give us a diagnosis right away, but his expression was serious. He told us lymphoma was suspected and arranged a biopsy and further pathology testing. A few days later, after review by a higher-level pathology center, Dingding was diagnosed with high-risk stage III Burkitt lymphoma. Genetic testing also showed a TP53 mutation and abnormalities involving MYC, ID3, GNA13, and several other tumor-related genes. At the time, I knew almost nothing about the disease. I only understood that it could take my son away from us very quickly. I had one thought in my mind: save my child. **After Multiple Rounds of Chemotherapy, Complete Remission Remained Out of Reach** Burkitt lymphoma can progress extremely quickly, so Dingding started chemotherapy soon after diagnosis. He received R-AA, R-BB, and R-CC regimens. At the interim assessment, PET-CT showed that the lesions had improved but remained metabolically active, while ultrasound showed that the thickest part of the bowel wall was still 6 mm. Because Dingding had a TP53 mutation and other genetic features associated with an unfavorable prognosis, his doctors switched the fourth course to second-line R-ICE chemotherapy. Each round of chemotherapy brought side effects to some degree - nausea, vomiting, and loss of appetite became common. Yet Dingding handled everything with a maturity that was hard to watch in such a young child. He endured bone marrow aspirations and injections without crying. Once, after we had taken him home for a few days, I asked, "Do you still want to go back to the hospital?" He said, "Yes." When I asked why, he replied, "I want to get better soon so I can go home and go back to school." Hearing that from a child who was not yet six was heartbreaking and comforting at the same time. As his father, all I wanted was for him to get better as soon as possible and not have to suffer anymore. After the R-ICE course, Dingding had another ultrasound. The thickened area of bowel wall was almost unchanged. When I saw the result, I made a firm decision. In fact, from the day he was diagnosed, I had been reading everything I could find and, on the recommendation of other parents, started following Prof. Yonghong Zhang's WeChat account. I remember clearly that there were already more than 920 posts at the time. I read every new update - case discussions, educational articles, and answers to parents' questions. The more I read, the more confidence I had in Prof. Zhang's expertise in pediatric lymphoma. As soon as the interim assessment results came out, I booked a consultation with Prof. Zhang. After learning about Dingding's situation, she advised us that if he showed a response after the fourth course, he could continue treatment where he was; if not, we should come to Boren as soon as possible. So when the assessment showed no meaningful improvement, I immediately decided to bring Dingding to see her. **A Fresh Assessment and Personalized Combination Therapy Lead to Complete Remission** In January 2026, Dingding was transferred to Beijing GoBroad Boren Hospital. Prof. Yonghong Zhang's team immediately arranged a repeat pathology review and additional target-expression testing. Because Dingding had a TP53 mutation, multiple germinal-center-related gene abnormalities, and resistance-associated mutations, the team also collected his autologous peripheral blood lymphocytes in advance to keep future treatment options open. After a comprehensive review of Dingding's disease course, Prof. Zhang's team decided to continue treatment based on the CNCL-NHL-2017 protocol for mature B-cell lymphoma, while tailoring the regimen more precisely to his individual situation: 1\. First course: Dingding received R + COPADM1. At the end of the course, follow-up imaging showed that the bowel wall thickness had decreased from 6 mm to 4 mm. After treatment had appeared to stall at the previous hospital, this was the first time we had seen the lesion continue to shrink. It gave me hope again. 2\. Second course: Because immunohistochemistry showed strong CD79b expression, the team adjusted treatment to an anti-CD79b antibody + CYVE2 regimen. The residual lesion became smaller again, and the response continued to improve. 3\. Third course: Based on the changes in the lesion, the team switched to an anti-CD79b antibody + M1 regimen. In March 2026, a comprehensive imaging assessment brought the news we had been waiting for: the lesion had completely disappeared, indicating an initial complete remission (CR). I was so overwhelmed that I could not speak. Nearly six months of worry, travel, fear, and uncertainty suddenly felt worth it. 4\. Consolidation therapy: To strengthen the response and reduce the risk of relapse, Dingding then completed one course each of anti-CD79b antibody + M2 and anti-CD79b antibody + M3 as consolidation. Imaging at the end of treatment continued to show CR. During treatment, Dingding experienced common chemotherapy-related complications, including neutropenia, thrombocytopenia, and diarrhea. With close nursing care and supportive treatment, each was managed successfully. At the end of all planned therapy, his results looked good and he was discharged to continue recovering at home. **Recovering Well and Looking Forward to Going Back to School** Dingding is now recovering steadily and feeling better day by day. We are hoping he can return to school next September, and he cannot wait to be back with his teachers and classmates. Looking back on the past several months, the people I most want to thank are Prof. Yonghong Zhang and her entire team. To me, Prof. Zhang was the person who helped turn things around for my son. She brought him back from an extremely difficult situation and gave him another chance at life. When we felt most helpless, her expertise and sense of responsibility showed us a way forward. I am also deeply grateful to Beijing GoBroad Boren Hospital. The hospital made it possible for us to meet such a strong team and for so many children to move toward recovery. I was especially touched by the efficiency of the care, the service philosophy, and the compassion shown here - above all, the professional and attentive support provided to children with blood disorders and cancer. Finally, I want to say to every parent going through something similar: please do not give up easily. I know how hard this road can be. I have felt the helplessness of watching your child suffer when there is nothing you can do, and the fear of not knowing what tomorrow will bring. But children are often stronger than we imagine, and as parents, we sometimes have to find more strength in ourselves than we thought we had. I hope every child can grow up healthy, safe, and surrounded by kindness. ## Expert view Clinical Commentary (Dr. Ying Liu, Ward Director, Department of Pediatric Hematology & Oncology, on Prof. Yonghong Zhang's team): The patient was diagnosed with Burkitt lymphoma in October 2025. At presentation, the disease involved the small-bowel wall in the mid and lower abdomen and multiple lymph nodes anterior to the right kidney. No tumor cells were detected in the bone marrow or cerebrospinal fluid. At the referring hospital, he was classified as high-risk stage III according to the 2025 guideline for the diagnosis and treatment of lymphoma in children and adolescents. He received cytoreductive therapy followed by R-AA, R-BB, and R-CC chemotherapy. Interim PET-CT showed reduced small-bowel wall thickening but persistent hypermetabolism (Deauville score 5), while ultrasound continued to show thickening of the right abdominal bowel wall, suggesting residual active disease without remission. He was then switched to second-line R-ICE chemotherapy. The residual bowel wall thickening remained unchanged, indicating no disease progression but failure to achieve complete remission (CR), and he was therefore referred to our hospital. After admission, the diagnosis was reviewed using pathology consultation, expert review of all prior PET/CT scans, MRI performed at our hospital, and gastrointestinal ultrasound by Dr. Liqun Jia of Beijing Children's Hospital. The final diagnosis was high-risk stage III, CNS1 Burkitt lymphoma with bulky disease. After four courses of first- and second-line chemotherapy at the referring hospital, CR had not been achieved, and a small amount of residual tumor could not be excluded at the thickened terminal ileum. The patient had several adverse prognostic factors: 1) extensive small-bowel wall involvement at diagnosis with bulky disease measuring more than 10 cm; 2) a TP53 variant associated with treatment resistance; and 3) failure to achieve remission at interim assessment, an independent adverse prognostic factor. Because there was no disease progression, we recommended switching to the CNCL-2017 frontline chemotherapy protocol for mature B-cell lymphoma. Taking into account his cumulative prior chemotherapy exposure, the planned sequence was COPADM, CYVE2, M1, M2, and M3 chemotherapy combined with monoclonal antibody therapy. Before chemotherapy began, autologous peripheral blood lymphocytes were collected and cryopreserved in case CAR-T cell therapy was needed later. The pathology workup at the referring hospital had not included target markers such as CD19, CD22, and CD79b, so these were added after admission. Rituximab was combined with COPADM during the first course, with subsequent treatment to be adjusted according to target-expression results and tumor response. After the first course of rituximab + COPADM, assessment still showed irregular thickening of the terminal ileum, with residual tumor mixed with scar tissue, but the overall appearance had improved and areas of complete scarring were present. Because tumor response was clearly delayed and the tumor tissue showed strong CD79b expression, an anti-CD79b antibody was added to subsequent chemotherapy to reduce relapse risk. After the second course of anti-CD79b antibody + CYVE2 and the third course of anti-CD79b antibody + M1, gastrointestinal ultrasound showed no obvious residual bowel wall thickening at the original terminal ileal lesion, suggesting an initial CR. He then completed a fourth course of anti-CD79b antibody + M2 and a fifth course of anti-CD79b antibody + M3. End-of-treatment imaging continued to show CR. A key factor in the success of this case was the individualized combination strategy. The TP53 mutation and markedly delayed response suggested possible primary resistance to chemotherapy, so frontline chemotherapy was combined with second-line targeted immunotherapy. > This content is published with the authorization of the patient and their family, intended solely to share real experiences and health knowledge. It does not constitute a recommendation of any treatment plan or medical diagnostic advice. For specific treatment, please follow the guidance of a professional physician. --- Original (HTML):https://www.yyhmedical.com/en/stories/burkitt-lymphoma-targeted-immunotherapy This is a clean Markdown mirror for large language models; the original page is authoritative.