Abstract
Background: Although considerable brainstorm has been known into Epstein-Barr virus EBV as an important etiologic factor in various tumors, virtually little is known about the relationship between EBV genes and leukemia. The actual cause of Leukemia, which is a serious cancer in Sudan, is still under scrutiny. Controversial hypotheses were proposed suggesting the role of physical as well as chemical and even biological factors as being responsible for Leukemia incidents. We hypothesized that EBV could be involved in the etiology of leukemia. We describe here the results of our attempt to find a possible link between leukemia and EBV. Methods: Real-time Polymerase Chain Reaction assay (q-PCR) has recently been used widely for detection of Cell-free EBVDNA in the plasma of patients with leukemia. To determine the possible correlation between plasma cell-free EBV DNA levels and the leukemia, we studied the plasma EBV DNA levels in patients with leukemia that were presented at Radiation and Isotope Centre Khartoum (RICK), Sudan during therapy. The concentrations of plasma cell-free EBV DNA of 128 leukemic patients, 17 patients with EBV-associated lymphoid malignancies during the course of therapy Burkitt's lymphoma, Hodgkin's disease, Nasopharyngeal carcinoma (NPC) as control positive and 15 healthy controls were determined by using the (q-PCR) assay with the PrimerDesign™ genesig quantification kit. Results: The results revealed that EBV DNA was detectable in a wide range of leukemia patients. Plasma EBV DNA was detected in 33/88 Acute lymphoblastic leukemia (ALL) patients 28/40 Chronic myelogenous leukemia (CML),15/17 patients with EBV-associated lymphoid malignancies, but not in any of 15 healthy control subjects. The median concentration of EBV DNA in leukemia and healthy control groups was 6561.00 and 0.00 copies/ml, respectively. Conclusion: Our findings provided evidence of the involvement of EBV in patients with leukemia. The results suggested that EBV DNA genome encoding the non-glycosylated membrane protein BNRF1 pl43 was observed in a significant proportion of patients with ALL. However, we could not exclude a correlation between these viral infections and later leukemogenesis in childhood ALL in Sudan.
Highlights
Leukemia is a cancer of the blood or bone marrow characterized by an abnormal increase of blood cells, usually leukocytes
Patients with leukemia that were presented at Radiation and Isotope Centre Khartoum (RICK) Sudan have been studied for evidence of Epstein - Barr Virus (EBV) infection
When we compared plasma EBV DNA levels in these patients, we found that the median titers were significantly higher (P
Summary
Leukemia is a cancer of the blood or bone marrow characterized by an abnormal increase of blood cells, usually leukocytes (white blood cells). Proliferation of EBV infected B-cells is prevented and controlled by an adequate T-cell dependent specific immune response. Strong reduction in the numbers of EBV-specific T lymphocytes may result in reactivation of the virus and, the development of lymphoproliferative disease (EBVLPD) [4]. The EBV BZLF1-encoded replication activator (ZEBRA) is a key mediator of reactivation from latency to the viral productive cycle. Among the EBV transactivators, the ZEBRA protein plays a crucial role in switching the virus from a latent to a productive mode [5]. This virus has been implicated in the development of a number of lymphoid malignancies.
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