Abstract
Burkitt's lymphoma (BL) is a frequent childhood B cell non-Hodgkin's lymphoma (NHL) in equatorial Africa associated with infections. Chronic Epstein Barr virus (EBV) infections can lead to host immune stimulation that may trigger genetic translocation(s), neoplastic transformation and proliferation of B cells. We determined EBV immunoglobulin G (IgG) in sera from participants and EBER-1 in tumour sections in confirmed BL cases at Moi Teaching and Referral Hospital (MTRH). A cross sectional study of children with clinical and histology diagnosis of NHL from whom BL status were confirmed by immunohistochemistry (IHC) was carried out. Epstein Barr virus IgG in sera was determine using Enzyme-linked immunosorbant assay, IHC for EBER-1 and MYC protein in tumour sections. Demographic and clinical information were obtained from questionnaires and hospital files respectively. Ninety three percent of sera were EBV IgG positive of which 31.7% were confirmed as BL. All jaw BL tumours and 86.7% of BL tumours carried EBER-1 antigen. Odds ratio of EBER-1 positive was 1.39, 95% CI: 0.16-12.19 in BL tumours regardless of age or gender. EBV infection among the study participants may be associated with BL, however, EBER-1 and MYC negative in BL tumours suggest alternative BL pathogenesis or variant.
Highlights
Burkitt's lymphoma (BL) is a tumour of the lymphoid tissues of three different variants; endemic, sporadic and immunodeficiency related
Ninety three (93) percent participants and 86.7% of BL cases were positive for Epstein Barr virus (EBV) immunoglobulin G (IgG) antibodies in serum, and EBER-1 positive respectively, while 13.33% did not carried latent EBV encoded small RNA 1 (EBER-1) (Figure 1)
Bivariate associations using a log-linear model, adjusted for age and gender, showed that BL occurrence was 1.39 times greater in participants who tested positive for EBER-1 than those who tested negative, adjusted odds ratio (AOR) 1.39, 95% CI: 0.16-12.19) regardless of age and gender
Summary
Burkitt's lymphoma (BL) is a tumour of the lymphoid tissues of three different variants; endemic (eBL), sporadic (sBL) and immunodeficiency related. Sporadic BL occurs worldwide with no geographic or climate association and no apparent infection in its aetiology. This variant usually presents as intra-abdominal swelling and rarely involves the jaw in young adults [3]. Majority of EBV infected B cells are recognized and eliminated by host T cell-mediated immune responses, but a fraction of the virus usually remain and enter latency I phase within the germinal centre where they express only three viral genes [4], characterized by expressions of small non coding EBV RNAs (EBERs) and EBNA1
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