The link between Epstein-Barr virus and lymphoma

Our magazine, Lymphoma Matters, comes out three times a year and is packed with useful information for people affected by lymphoma. It covers the latest developments in diagnosis and treatment, symptoms management, stories of how other people are living with lymphoma and how you can get involved to support our work.

Our Winter 2023 edition includes a piece written by Viracta Therapeutics about the link between the Epstein-Barr virus and several types of lymphoma (see page 31). The article is also shared below: 

Epstein-Barr virus (EBV) is a member of the herpes virus family and is one of the most common human viruses. Approximately 90 to 95% of adults throughout the world are infected with EBV. Most people become infected during childhood and may never know, due to having only mild symptoms or no symptoms at all. 

The virus spreads from person to person through bodily fluids, particularly saliva. However, you can also get the virus by sharing personal items, such as tooth brushes or eating utensils, with someone who has an active EBV infection. The most well-known EBV infection is mononucleosis or glandular fever. 

After you get an EBV infection, the virus becomes latent or inactive in your body. In very rare cases, under certain circumstances of immunosuppression, the virus can reactivate, and EBV-associated diseases may arise.

Interestingly, EBV was originally discovered through its association with Burkitt lymphoma, a rare but fast growing cancer mostly found in children and young adults in Africa. The discovery began in 1961 when Denis Burkitt, an Irish surgeon, presented a newly discovered lymphoma during a lecture at Middlesex Hospital Medical School, attended by a medical virologist, Anthony Epstein. Epstein was fascinated by this new lymphoma and asked Burkitt for tumor samples to be sent to him. He then began focusing on isolating the viral cause of Burkitt Lymphoma. 

In 1964, Epstein and his colleagues Yvonne Barr and Bert Achong, published their discovery of viral particles in lymphoblasts isolated from a patient with Burkitt lymphoma. This virus, EBV, became the first human cancer virus to be described, and its discovery paved the way for further research into viruses associated with cancer.

We now know mutations in cells infected with EBV can lead to cancerous changes and increase the risk of developing certain rare cancers like B, T and NK lymphomas as well as nasopharyngeal and gastric cancers. For example, 5-15% of all diffuse large B-cell lymphomas, 40-65% of all peripheral T-cell lymphoma, and 60-80% of all post-transplant lymphoproliferative disorders are associated with EBV. However, EBV-associated cancers are uncommon, and most people infected with EBV will not develop cancer. Overall, it’s estimated that EBV infection contributes to about 2% of cancers worldwide. 

Experts are still trying to identify these specific mutations and why EBV infection seems to cause them.

Targeted therapies are being developed to treat EBV-associated lymphomas. These include small molecule inhibitors, immunotherapy, and cell therapies. 

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