Bone marrow biopsy with IHC is in keeping with Burkitt’s lymphoma (EBV-negative).
The diagnosis is confirmed by interphase FISH studies:
FISH: IGH-MYC fusion POSITIVE t(8;14)(q24;q32) [35/100] / BCL6 NOT rearranged  /
BCL2 NOT rearranged 
PET-CT shows markedly increased FDG uptake throughout the axial skeleton in keeping with diffuse marrow infiltration. No other areas of disease are identified.
LDH is markedly elevated at 7900. His ECOG is 1.
What treatment would you offer this patient (no right answer)?
Does the patient’s HIV status affect the treatment options and what would you do with the antiretroviral therapy?
What are the potential complications of treatment and how would you reduce the risk of these complications?
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