Burkitt's Lymphoma and the Role of Epstein-Barr Virus

Abstract

Burkitt's lymphoma is the most common childhood cancer in Africa. Most prevalent in areas endemic for malaria, the disease, a malignant growth of lymphoid tissue, usually presents itself as a large tumour of the jaw. When first characterized in the 1950s, the lymphoma was thought to spread by some infectious agent. Subsequent research indicates that the frequent involvement of an infectious agent is but one factor in a more complex aetiology. Today, Burkitt's lymphoma is considered an example of multistep carcinogenesis. Each step in the process results from a different agent. The agent in the first step is the Epstein-Barr virus, which infects B cells of the immune system causing a proliferation of these cells. The second step, malarial infection, furthers the proliferation of B cells providing a large population of cells available for a chromosomal translocation which represents the third step in the formation of the lymphoma. The chromosomal translocation places a cancer causing gene, c-myc, in close proximity to an active antibody-encoding its proliferation resulting in a cell capable of unlimited growth which serves as the nucleus of a B cell lymphoma.

A Multifactorial Role for P. falciparum Malaria in Endemic Burkitt's Lymphoma Pathogenesis

“…Endemic Burkitt's lymphoma (eBL) is an extremely common tumor of young children in tropical Africa [1]. Genetic, phenotypic and transcriptional analysis suggests that it originates from germinal center (GC) cells [2], [3] although it actually grows in extrafollicular locations.…”

“…eBL is also closely associated with two infectious agents, P. falciparum malaria and Epstein-Barr virus (EBV) [1], [11], [12]. The distribution of the tumor in Africa closely matches that of hyper- and holoendemic malaria [12] while EBV was originally discovered in eBL tumor biopsies.…”

Outcome and haemato-toxicity of two chemotherapy regimens for childhood non-Hodgkin's Lymphoma in a Kenyan Hospital

“…Burkitt's lymphoma (BL) is a rapidly growing childhood tumour characterised by mature small non-cleaved B-cells and commonly presents as a jaw or abdominal swelling in tropical Africa (1,2). In resource poor countries like Kenya, diagnosis is purely made on microscopy thus making it difficult to differentiate variants of BL and other non-Hodgkin's lymphoma accurately.…”

Antibody and complement levels in patients with Burkitt's lymphoma

“…The etiology of Burkitt's lymphoma (BL) has been reported by several authors 1,2,3,4 . One of Burkitt's early papers discussed the potential role of host immunity to BL.…”