The Possible Involvement of Epstein-Barr virus In the Etiology of Leukemia

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.