From the Guidelines
Yes, Epstein-Barr virus (EBV) can cause lymphoma, particularly in immunocompromised individuals, as evidenced by its association with several types of lymphomas, including Burkitt lymphoma, Hodgkin lymphoma, and certain types of non-Hodgkin lymphomas 1. The virus infects B lymphocytes and can transform them through various viral proteins that promote cell survival and proliferation. EBV establishes a lifelong infection in most people without causing cancer, but in some cases, genetic factors, immune system deficiencies, or environmental factors may allow EBV-infected cells to escape immune surveillance and develop into lymphoma. Some key points to consider include:
- The risk of EBV-related lymphoma is significantly higher in people with compromised immune systems, such as those with HIV/AIDS or organ transplant recipients taking immunosuppressive medications 2.
- EBV infection is common worldwide, infecting over 90% of adults, but only a small percentage of infected individuals will develop lymphoma, indicating that additional factors beyond viral infection are necessary for cancer development.
- In HIV-positive populations, nearly 90% of Hodgkin lymphoma cases are Epstein-Barr virus–associated, and these individuals often present with more advanced disease, including B symptoms and bone marrow involvement 1. The current management of EBV-related post-transplant lymphoproliferative disorders includes prophylaxis, preemptive therapy, and targeted therapy, with rituximab, reduction of immunosuppression, and EBV-specific cytotoxic T-cell therapy recommended as first-line therapy 2.
From the Research
Epstein-Barr Virus and Lymphoma
The Epstein-Barr virus (EBV) is associated with various types of lymphomas, including:
- Burkitt lymphoma
- Hodgkin lymphoma
- Post-transplant lymphoproliferative disorders
- Diffuse large B-cell lymphoma (DLBCL) 3, 4, 5 EBV can contribute to the development of these lymphomas by infecting B cells and promoting uncontrolled cell growth and lymphoproliferative disorders 3, 6.
Mechanisms of EBV-Associated Lymphomagenesis
The exact mechanisms of EBV-associated lymphomagenesis are complex and not fully understood, but research suggests that:
- EBV infection can lead to the activation of signaling pathways that promote cell growth and survival 3, 4
- The virus can also evade the host immune system, allowing infected cells to proliferate unchecked 5, 6
- Genetic alterations and mutations in the host cells can also contribute to the development of EBV-associated lymphomas 4, 7
Prognostic Utility of EBV in Lymphoma
The presence of EBV in lymphoma cells can have prognostic implications, with some studies suggesting that: