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Four-hundred-twenty-one Americans diagnosed as having Burkitt's lymphoma (BL), 409 from the United States, were studied by the American BL Registry to obtain information about the cause and control of this disease. Of these 421 cases, 256 were confirmed by our pathologists as being morphologically indistinguishable from African BL, A relationship between age and organ involvement was observed; cervical lymph nodes, ileum, and nasopharynx were initial sites of involvement primarily in younger patients. Although the Epstein-Barr virus (EBV) was less frequently associated with American BL than African, a high antibody titer to the EBV capsid antigen was associated with a more favorable prognosis. American BL resembled African BLs time-space clustering, male predominance, and excellent response to chemotherapy. Unlike African BL, however, more patients had involvement of cervical lymph nodes and bone marrow at an early stage of disease. American BL appears to be a more heterogeneous disease than African BL.
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