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The Connection Between Epstein-Barr Virus and Non-Hodgkin Lymphoma

The Connection Between Epstein-Barr Virus and Non-Hodgkin Lymphoma

Published on October 16, 2020

Does Epstein-Barr Virus Increase Lymphoma Risk?

Not everyone knows the origin of their cancer. What we do know is that lifestyle factors, such as what we eat and drink and how much we exercise can have an effect. Our genes and their mutations also play a role. And for some cancers, such as non-Hodgkin lymphoma (NHL), certain viruses, including Epstein-Barr virus (EBV), may be a factor.

When your immune system is affected by a virus such as EBV, it can put you more at risk for certain conditions like NHL, a cancer that originates in your lymphatic system, the disease-fighting network spread throughout your body.

What is Epstein-Barr Virus?

If you have ever had mononucleosis, also known as mono, infectious mononucleosis, or "the kissing disease,” then you probably have EBV in your system. You can find out by having a blood test, called a titer, to check for immunity. If your test results show antibodies to EBV, it means you were infected with the virus at some point in your life.

Epstein-Barr virus is a member of the herpes virus family, and one of the most common viruses on the planet.1 Many people are infected with EBV during childhood and never know it. Others experience flu-like symptoms for a brief period. The virus lays dormant for many people. Does having EBV mean that you’re definitely more at risk for certain types of NHL? Not necessarily. The connection happens when the body is unable to regulate the virus.

Symptoms of Infectious EBV

If you have an active Epstein-Barr virus infection, you may experience some of these symptoms:

  • extreme fatigue
  • fever
  • sore throat
  • head and body aches
  • swollen lymph nodes in the neck and armpits
  • swollen liver and/or spleen
  • rash1

EBV’s Connection to NHL

People age 65 years and older who had EBV at one time are at a higher risk for developing B-cell NHL because of the way the immune system ages over time.2 An EBV infection reprograms or hijacks B cells to become cancerous.3 But promising new therapies are becoming available.

Targeted therapies are being developed to treat EBV-associated B-cell lymphomas. These include small molecule inhibitors, immunotherapy, cell therapy, preventative and therapeutic vaccines to counteract these conditions.4

New Therapies to Treat B-Cell Lymphomas

Dr. Sarah Rutherford, assistant professor of Medicine in the Division of Hematology/Oncology at Weill Cornell Medicine, recently discussed a promising lymphoma clinical trial during an interview with Patient Power’s Esther Schorr. “I had the privilege of working on a clinical trial with a number of other investigators across the country of a novel targeted drug, venetoclax (Venclexta), in combination with dose-adjusted EPOCH-R in aggressive B-cell lymphomas,” Dr. Rutherford said.

“We found that the particular dose of venetoclax, which is a BCL-2 inhibitor, on a schedule of five days along with chemotherapy was well-tolerated in this patient population. BCL-2 is either rearranged or overexpressed in many of the aggressive B-cell lymphomas and this drug, venetoclax, is a very promising agent to combine with chemotherapy in this patient population,” she added.

Risk Factors for Non-Hodgkin Lymphoma

Like many cancers, the risk factors for NHL can vary. In addition to an EBV infection, other known risk factors include:

  • age
  • gender (affecting more men than women)
  • race (affecting white people more than other races)
  • immune system dysfunction
  • exposure to chemicals

Researchers are connecting the dots between viruses and other risk factors for cancer, and with specialized treatments being tested, we should have more therapeutic options very soon.

~Lauren Evoy Davis

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References:

1Epstein-Barr Virus and Infectious Mononucleosis. CDC

2Daroontum T, Kohno K, Inaguma Y, et al. Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma arising in patient with a history of EBV-positive mucocutaneous ulcer and EBV-positive nodal polymorphous B-lymphoproliferative disorder. Pathol Int. 2019 Jan;69(1):37-41

3Mrozek-Gorska PM, Buschle A, Pich D. Epstein–Barr virus reprograms human B lymphocytes immediately in the prelatent phase of infection. PNAS August 6, 2019.

4Pei Y, Wong JHY, Robertson ES. Targeted Therapies for Epstein-Barr Virus-Associated Lymphomas. Cancers (Basel). 2020 Sep 9;12(9):E2565.


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