Genome-wide discovery of somatic coding and non-coding mutations in pediatric endemic and sporadic Burkitt lymphoma

Bruno M. Grande, Daniela S. Gerhard, Aixiang Jiang, Nicholas B. Griner, Jeremy S. Abramson, Thomas B. Alexander, Hilary Allen, Leona W. Ayers, Jeffrey M. Bethony, Kishor Bhatia, Jay Bowen, Corey Casper, John Kim Choi, Luka Culibrk, Tanja M. Davidsen, Maureen A. Dyer, Julie M. Gastier-Foster, Patee Gesuwan, Timothy C. Greiner, Thomas G. Gross, Benjamin Hanf, Nancy Lee Harris, Yiwen He, John D. Irvin, Elaine S. Jaffe, Steven J.M. Jones, Patrick Kerchan, Nicole Knoetze, Fabio E. Leal, Tara M. Lichtenberg, Yussanne Ma, Jean Paul Martin, Marie-Reine Martin, Sam M. Mbulaiteye, Charles G. Mullighan, Andrew J. Mungall, Constance Namirembe, Karen Novik, Ariela Noy, Martin D. Ogwang, Abraham Omoding, Jackson Orem, Steven J. Reynolds, Christopher K. Rushton, John T. Sandlund, Roland Schmitz, Cynthia Taylor, Wyndham H. Wilson, George W. Wright, Eric Y. Zhao, Marco A. Marra, Ryan D. Morin and Louis M. Staudt

Key points

  • Tumor EBV status is more strongly associated with distinct genetic and etiological mechanisms than geographic origin.

  • EBV-positive BL genomes feature fewer driver mutations despite their greater mutational load that is partly due to increased AICDA activity.


Though generally curable with intensive chemotherapy in resource-rich settings, Burkitt lymphoma (BL) remains a deadly disease in older patients and in sub-Saharan Africa. Epstein-Barr virus (EBV) positivity is a feature in over 90% of cases in malaria-endemic regions and up to 30% elsewhere. However, the molecular features of BL have not been comprehensively evaluated when taking into account tumor EBV status or geographic origin. Through an integrative analysis of whole genome and transcriptome data, we show a striking genome-wide increase in aberrant somatic hypermutation in EBV-positive tumors, supporting a link between EBV and AICDA activity. In addition to identifying novel candidate BL genes such as SIN3A, USP7, and CHD8, we demonstrate that EBV-positive tumors had significantly fewer driver mutations, especially among genes with roles in apoptosis. We also found immunoglobulin variable region genes that were disproportionally used to encode clonal B-cell receptors (BCRs) in the tumors. These include IGHV4-34, known to produce autoreactive antibodies, and IGKV3-20, a feature described in other B-cell malignancies but not yet in BL. Our results suggest that tumor EBV status defines a specific BL phenotype irrespective of geographic origin with particular molecular properties and distinct pathogenic mechanisms. The novel mutation patterns identified here imply rational use of DNA-damaging chemotherapy in some BL patients and targeted agents such as the CDK4/6 inhibitor palbociclib in others, whereas the importance of BCR signaling in BL strengthens the potential benefit of inhibitors for PI3K, Syk and Src family kinases among these patients.

  • Submitted September 10, 2018.
  • Accepted December 22, 2018.