95 A new systematic review has shed new light on the factors influencing survival rates in adults with Burkitt lymphoma, a rare and aggressive form of non-Hodgkin lymphoma. Published in the journal Cancer Medicine, the study synthesises evidence from 36 studies involving over 10,000 patients worldwide, offering critical insights that could shape future treatment strategies for this fast-progressing disease. Conducted by an international team, including researchers from the Canary Islands Health Research Institute and France’s Institut Gustave Roussy, the review highlights how age, race, and specific treatments play pivotal roles in patient outcomes. Burkitt lymphoma, though uncommon, poses significant challenges due to its rapid growth and tendency to present at an advanced stage. The disease manifests in three forms: endemic, often linked to facial tumours in children; sporadic, typically affecting the abdomen or bone marrow; and immunodeficiency-associated, frequently seen in HIV patients. This review focused exclusively on adults, analysing data from studies spanning 2008 to 2022, with the aim of identifying prognostic factors that influence survival. One of the most striking findings is the impact of age. Older patients, particularly those over 60, face significantly poorer overall survival and progression-free survival compared to their younger counterparts. The study suggests that this may be due to reduced tolerance for the intensive chemotherapy regimens required, such as hyper-CVAD or CODOX-M/IVAC, which younger adults are more likely to withstand. Alongside age, race emerged as a key determinant, with Black patients showing lower overall survival and relative survival rates, pointing to potential disparities in disease progression or access to care. The review also identified physical condition as a crucial factor. Patients with a higher performance status, meaning they struggle with daily activities, experienced worse survival outcomes over periods ranging from two to ten years. Central nervous system involvement and bone marrow infiltration were similarly linked to reduced survival, underscoring the disease’s aggressive nature when it spreads beyond initial sites. Conversely, higher albumin levels in the blood were associated with better survival, offering a potential marker for monitoring patient health. Treatment approaches provided some of the most promising results. Patients receiving rituximab, a targeted therapy, or methotrexate, a potent chemotherapy drug, demonstrated improved survival rates. These findings reinforce the value of incorporating such treatments into standard care, particularly for those able to tolerate their intensity. However, the study found no significant survival differences between men and women, nor did HIV status or risk stratification consistently alter outcomes, suggesting these factors may be less decisive than previously thought. This comprehensive review, supported by the European Reference Networks, marks a significant step forward in understanding Burkitt lymphoma. Its rigorous methodology, including a broad literature search and meta-analyses, provides a solid foundation for clinicians to refine treatment plans. As the disease remains a formidable foe, these insights could pave the way for personalised therapies, potentially sparing some patients excessive treatment while identifying others who might benefit from emerging options like bispecific antibodies or CAR-T cell therapy.