Viral lymphomagenesis

Several viruses have been associated with lymphomageneisis. Epstein-Barr virus is associated with B-cell lymphomas in immunosuppressed patients as well as some cases of Burkitt's lymphoma, some T and natural killer lymphomas and approximately 40% of cases of Hodgkin's disease. Human T-cell leukemia virus 1 and human herpes virus 8 genomes are also found in tumor cells in some types of lymphoma, while there are epidemiological data linking hepatitis C and lymphoma. The presence of the viral genome in all these malignancies offers the prospect for therapeutic interventions targeting virus-encoded proteins.

Immunotherapy with antigen-specific T cells has efficacy in immunosuppressed patients with Epstein-Barr virus-associated posttransplant lymphoma and in some patients with Epstein-Barr virus-positive Hodgkin's disease. Preclinical studies are focusing on agents that block Epstein-Barr virus-encoded proteins or induce lytic cycle agents. In hepatitis C virus-positive lymphomas, responses have been reported with immune modulation. Increasing knowledge of cellular pathways modulated by viruses provides additional potential targets for therapy.

While the contribution to oncogenesis of Epstein-Barr virus in B-cell lymphoproliferative disease arising in immunosuppressed patients is clear cut, its role and that of other viruses in lymphomagenesis is less clear in lymphomas developing in immunocompetent patients. The presence of viral genomes in these lymphomas, however, offers targets for intervention and approaches under evaluation include adoptive immunotherapy, interferon, and small molecules targeting aspects of virus biology.