Understanding the Role of EBV Infection in Lymphomagenesis

Epstein-Barr virus (EBV) is associated with several lymphomas including Burkitt lymphoma; EBV-positive diffuse large B cell lymphoma, not otherwise specified; post-transplant lymphoproliferative disorders; extranodal NK/T cell lymphoma, nasal type; and chronic active EBV disease. EBV encodes several oncoproteins important in terms of B-cell immortalization; it also encodes proteins that potentiate lymphomagenesis. Host gene mutation/modification followed by EBV infection triggers lymphomas, though the host driver genes differ among lymphomas. Both congenital and acquired immunodeficiency greatly compromise cellular immunity and increase the rates of EBV-associated lymphoma. PD-1/PD-L1 pathway blockade is effective in treating EBV-associated lymphomas, as PDL-1 is overexpressed in these diseases, and is attributable to structural abnormalities in the 3' untranslated region and/or upregulation by viral genes.