The
evidence connecting Epstein Barr virus (EBV) with some
kinds of lymphoma is building. Tere is a
strong association between EBV an Burkitt's lymphoma, but other factors
may also be needed for a cancer to develop, such as suppressed
immunity.
However, being
EBV-positive (a very common virus) does not mean you will develop a
lymphoma, or that you are at considerably high risk.
About Epstein
Barr Virus: Evidence is building that Epstein-Barr
virus can "change normal cells into cancerous ones."
"That virus already is known to cause infectious mononucleosis in
humans and has been associated with such malignancies as Burkett’s
lymphoma, Hodgkin’s lymphoma and nose and throat cancer. It is
especially hazardous to AIDS patients and other patients whose immune
systems have weakened." unc.edu
"The Epstein Barr
virus (EBV) was the first described oncovirus (cancer causing virus),
which has been associated with the development of a variety of
lymphoproliferative disorders, such as Burkitt, primary CNS,
NK/T-cell, plasmablastic and Hodgkin lymphoma.
EBV infection occurs early in childhood, and approximately 90 to 95%
of adults worldwide are EBV-seropositive.
EBV expression has also been reported in patients with diffuse large
B-cell lymphoma (DLBCL). " (Beltran, et al.) ncbi.nlm.nih.gov/
Medinfo.edu:
Technical
background on EBV
"Epstein-Barr virus was
discovered by observation of herpes-like virions in electron
micrographs of biopsies of Burkitt's lymphoma. It was later identified
as the cause of infectious mononucleosis and nasopharyngeal
carcinoma.
In immunodeficient individuals it
can cause B-cell lymphomas. The receptor for EB virus is also the
receptor for the C3d component of the complement system. It is
expressed only on B-cells and epithelial cells of the oropharynx and
nasopharynx. Infection of the epithelial cells of the oro- and
nasopharynx is permissive.
Virus is shed into the saliva and
infects B lymphocytes in lymphatic tissue and blood. Infection of B
cells can cause a latent infection, stimulate their growth, or
immortilize the cells. In mononucleosis the characteristic
lymphocytosis is due to activation and proliferation of supressor
(CD8) T cells. This causes the swollen lymph glands as well as the
hepato- and splenomegaly.
The disease is quite mild in
children but more severe in adolescents and adults. It produces
life-long immunity. Thus a good strategy for control of disease would
be to ensure infection of children at a young age. Clinical diagnosis
of mononucleosis is usually based on the presence of lymphocytosis,
atypical lymphocytes, pharyngitis, and the presence of heterophile
antibody (Ab to sheep and horse RBC's), which is the basis for the
monospot test." medinfo.ufl.edu
"In normal individuals, latent
EBV infection is controlled by humoral immunity, cytotoxic T cells,
and the interferon (IFN) system (Jabs et al., 1996)." uq.edu.au
Types
of lymphomas associated with EBV
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Burkitt's Lymphoma PAL
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Cutaneous Lymphoma Associated With Epstein-Barr
Virus Infection in 2 Patients Treated With Methotrexate mayo.edu
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EBV-associated primary central nervous system
lymphoma ASCO
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Epstein-Barr virus polymorphic B-cell lymphoma associated with leukemia and with congenital immunodeficiencies
jco.org
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Hodgkin's Lymphoma PAL
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Diffuse Large B-Cell
Lymphomas
The impact of Epstein-Barr virus
status on clinical outcome in diffuse large B-cell lymphoma.
(Park, et al) http://bloodjournal.hematologylibrary.org/cgi/content/full/110/3/972
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Other - many types of lymphoma can be EBV-positive
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Post-transplantation lymphoma
tpis.upmc.edu
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T-/NK-cell lymphoma PAL
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Staging: Staging
refers to the how widespread the disease is. Imaging
tests (CT MRI, PET, Gallium) and bone marrow biopsies are commonly
done to estimate this. See Staging for
more detail.
Treatment:
The type of treatment will depend on the type of lymphoma, how
aggressive it is, and other clinical details, such as the patient's
age, general health, and the number and types of prior
treatments. Also see Treatment
Decisions
Resources
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