Pilot Study of Epstein Barr virus Infection at the Onset of Acute Lymphoblastic Leukaemia in Egyptian Children

Abstract

Background: There are no reports from our region about the association of Epstein Barr virus (EBV) with acute lymphoblastic leukemia in children. Aim: The aim of the present study is to assess the presence of EBV in children with acute incidence of acute lymphoblastic leukemia by the use of specific immunoglobulins assay for capsid protein antigens and molecular method. Material and Method: The study included 93 children at the onset of acute lymphoblastic leukemia. In addition, 100 healthy children with matched age and sex were included as control group. Blood samples were obtained from each participant of the study and sera were separated. Sera were subjected to serological studies of EBV specific immunoglobulins G (IgG) and M (IgM) for viral capsid antigens by enzyme linked immunosorbant assay and molecular study of EBV DNA by polymerase chain reaction (PCR). Results: Immunoglobulin G was the most common marker among children with acute lymphoblastic leukemia (29%) followed by EBV DNA (25.8%) and then IgM (12.9%). In control group 15 children were positive for EBV IgG (15%) and 5 children were positive for IgM (5%) and none were positive for EBV DNA. There was statistically significant difference in presence of Ig G (P=0.0001) and EBV DNA (P=0.04) between patients and control. Younger age (3.4 ± 1.6, P=0.005) and lower platelets counts (43±1.0 x103, P=0,027) are associated with positive EBV viremia in patients. Conclusion: From this study we can conclude that Epstein Barr virus is common in children at the onset of acute lymphoblastic leukemia. Younger age is associated with positive EBV viremia in patients. The infection is usually asymptomatic and diagnosed only by laboratory tools. The combination of serology with molecular method for detection of this virus is the ideal way.