Epstein-Barr virus and non-Hodgkin lymphoma: A study in Kermanshah, Iran

Ali Shahriari-Ahmadi, Babak Izadi, Masoud Sadeghi, Mehrdad Payandeh, Edris Sadeghi

American Journal of Cancer Prevention

Epstein-Barr virus and non-Hodgkin lymphoma: A study in Kermanshah, Iran

Ali Shahriari-Ahmadi1, Babak Izadi2, Masoud Sadeghi3, 4,, Mehrdad Payandeh2, Edris Sadeghi3, 4

1Rasool-Akram Hospital, Oncology and Hematology ward, Iran University of Medical Sciences, Tehran, Iran

2Department of Medical Oncology, Kermanshah University of Medical Sciences, Kermanshah, Iran

3Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran

4Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran

Abstract

Background: Epstein-Barr virus (EBV) infection is highly associated with specific subtypes of malignant lymphoma such as types of aggressive non-Hodgkin lymphoma (NHL). We aimed to evaluate the prevalence of EBV in NHL and its association with clinical parameters. Patients and Methods: twenty cases entered to our study. After re-blocking of previous paraffin embedded specimens, new slides were prepared and DNA was extracted. DNA contents were confirmed by spectrophotometery. Then PCR assay was used for total DNA and its product evaluate for presence of EBV by electrophoresis. Results: The mean age at diagnosis for all patients was 45±13 years (range, 28-73) years that 12 patients (60%) were male. Based on histopathology reports, 13 patients (65%) had immunoblastic Lymphoma, 5 (25%) had burkitt Lymphoma and 2 (10%) had LL (lymphoblastic Lymphoma). Conclusion: There is no EBV infection in NHL patients with LLs and percent of EBV infection in our study is lower than other studies.

Cite this article:

  • Ali Shahriari-Ahmadi, Babak Izadi, Masoud Sadeghi, Mehrdad Payandeh, Edris Sadeghi. Epstein-Barr virus and non-Hodgkin lymphoma: A study in Kermanshah, Iran. American Journal of Cancer Prevention. Vol. 3, No. 5, 2015, pp 91-93. http://pubs.sciepub.com/ajcp/3/5/4
  • Shahriari-Ahmadi, Ali, et al. "Epstein-Barr virus and non-Hodgkin lymphoma: A study in Kermanshah, Iran." American Journal of Cancer Prevention 3.5 (2015): 91-93.
  • Shahriari-Ahmadi, A. , Izadi, B. , Sadeghi, M. , Payandeh, M. , & Sadeghi, E. (2015). Epstein-Barr virus and non-Hodgkin lymphoma: A study in Kermanshah, Iran. American Journal of Cancer Prevention, 3(5), 91-93.
  • Shahriari-Ahmadi, Ali, Babak Izadi, Masoud Sadeghi, Mehrdad Payandeh, and Edris Sadeghi. "Epstein-Barr virus and non-Hodgkin lymphoma: A study in Kermanshah, Iran." American Journal of Cancer Prevention 3, no. 5 (2015): 91-93.

Import into BibTeX Import into EndNote Import into RefMan Import into RefWorks

At a glance: Figures

1. Introduction

Epstein-Barr virus (EBV) is an ancient virus, and has probably coevolved with its different hosts over the last 90–100 million years [1]. During the recent decade, methods for detecting and quantifying cellular and extracellular EBV in peripheral blood have improved significantly. Initially applicable only to small series of patients, modern techniques such as real-time PCR have now made large studies feasible. However, the majority of these have been performed to investigate EBV viral loads in specific diseases, and knowledge on EBV viral load in healthy individuals has mainly been generated from the control groups, rarely selected randomly from the population [2]. EBV infection is highly associated with specific subtypes of malignant lymphoma [3] such as types of aggressive non-Hodgkin lymphoma (NHL) [4, 5]. Individuals with primary or secondary immunodeficiency are susceptible to developing B cell lymphoproliferation due to outgrowth of EBV-infected B cells that express type III latency characterized by expression of all nine latent-cycle EBV antigens. These cells would normally be susceptible to control by EBV-specific T cells, and strategies to restore EBV-specific immune responses may be effective therapeutically [4]. The prevalence of EBV was very high among B cell lymphomas particularly Burkitt lymphoma. This is not surprising as it has been previously reported by Olweny and others [6, 7]. However, the diffuse large B cell lymphomas (DLBCL) showed weaker EBV association of 44.4%. This is similar to what Cool found in neighbouring Kenya: 43% prevalence [8].

We aimed to evaluate the prevalence of EBV in NHL and its association with clinical parameters.

2. Patients and Methods

By evaluation of patients in cancer network, 20 cases entered to our study. After re-blocking of previous paraffin embedded specimens, new slides were prepared and DNA was extracted. DNA contents were confirmed by spectrophotometery. Then PCR assay was used for total DNA and its product evaluate for presence of EBV by electrophoresis.

3. Results

The mean age at diagnosis for all patients was 45±13 years (range, 28-73 years). Twelve patients (60%) were male and 8 patients (40%) were female (Table 1). Involvement anatomic sites were GI, cervical, inguinal, femoral, Para aortic, soft tissue, tonsilar, omentum and mediastenal for 8 patients (40%), 2 (10%), 2 (10%), 2(10%), 2 (10%), 1 (5%), 1 (5%), 1 (5%) and 1(5%), respectively. Based on histopathology reports, 13 patients (65%) had IL (Immunoblastic Lymphoma), 5 (25%) had BL(Burkitt Lymphoma) and 2 (10%) had LL(Lymphoblastic Lymphoma) (Figure 1- Figure 3).

Table 1. The characteristics for all patients (n=20)

Figure 1. Histopathology image for Lymphoblastic Lymphoma
Figure 3. Histopathology image for Immunoblastic Lymphoma

Out of 20 patients, 5 cases were EBV DNA- positive that 2 cases had age≤ 45 years and 3 cases had age>45 years. Of 5 cases, 3 cases were male and 2 cases were female. Also, 3 cases had IL, 2 cases had BL and there is no LL (Table 2).

Table 2. The results of electrophoresis for EBV in samples (n=20)

4. Discussion

EBV causes rare, malignant lymphomas. The role of EBV in other NHLs remains unclear, but mildly reduced immune function could lead to reactivation of EBV and subsequent NHL [9]. These data support the theory that chronic EBV infection is often found in association with cases of NHL of B-cell origin [10]. EBV has been classically associated with 3 malignancies, Burkitt lymphoma, B-cell lymphoproliferative syndromes, and nasopharyngeal carcinoma, and more recently with Hodgkin disease, T-cell lymphomas, and gastric and breast carcinomas, as well as with leiomyosarcoma and leiomyoma associated with immunosuppression [11]. Eight out of the 32 (25%) non-Hodgkin lymphoma cases showed EBV infection [11]. The high detectability of EBV-positive cases both in the group of B-cell NHLs (77%) [12]. In a study, the mean age of the patients with NHL was 53.6 years that a total of 50 (70.4%) were male and 21 (29.6%) were female. Some 9 (12.7%) out of 71 cases were positive for EBV-LMP-1 immunostaining, 2 (22.2%) follicular lymphoma cases, 1 (11.1%) case of T-cell lymphoblastic lymphoma, 4 (44.4%) cases of diffuse large B cell lymphomas, 1 (11.1%) mantle cell lymphoma and 1 (11.1%) angioimmunoblastic T cell lymphoma case [13]. In our study, out of 20 patients with NHL, 5 patients (25%) had EBV infection that mean age for the patients was 45 years and 12 patients (60%) were male.

Burkitt lymphoma (BL) can be classified into three forms which differ in geographic distribution and EBV association: endemic (eBL), sporadic (sBL) and HIV‐associated BL. There is a low background incidence of BL worldwide (sBL), which is rarely associated with EBV and accounts for 1–2% of adult lymphoma in Western Europe and America, but eBL is associated with (EBV) in over 95% of cases and is predominant in the equatorial belt of Africa and other parts of the world where malaria is hyperendemic [14]. In other study, the majority (92%) of the Burkitt lymphomas and only 34.8% of the diffuse large B cell lymphomas were EBV positive. None of the precursor B lymphoblastic lymphomas or the mantle cell lymphomas showed EBV integration in the lymphoma cells [15]. Also, EBV was associated with 90% of immunoblastic cases [16]. In this study, 40% patients with BL and 23.1% with IL had EBV infection that is lower than other results and also none of LLs had EBV infection.

The association of EBV with Hodgkin's disease seems to depend on factors such as country of residence, histological subtype, sex, ethnicity, and age [17]. In our study, there is no correlation between age and sex with EBV infection.

5. Conclusion

There is no EBV infection in NHL patients with LLs and percent of EBV infection in our study is lower than other studies.

References

[1]  McGeoch DJ, Cook S, Dolan A, Jamieson FE, Telford EA. Molecular phylogeny and evolutionary timescale for the family of mammalian herpesviruses. J Mol Biol. 1995. 247 (3): 443-58.
In article      View Article  PubMed
 
[2]  Hjalgrim H, Friborg J, Melbye M. In: Arvin A, Campadelli-Fiume G, Mocarski E, Moore PS, Roizman B, Whitley R, Yamanishi K, editors. Human Herpesviruses: Biology, Therapy, and Immunoprophylaxis. Cambridge: Cambridge University Press; 2007. Chapter 53. The epidemiology of EBV and its association with malignant disease.
In article      
 
[3]  Mitarnun W, Suwiwat S, Pradutkanchana J. Epstein-Barr virus-associated extranodal non-Hodgkin's lymphoma of the sinonasal tract andnasopharynx in Thailand. Asian Pac J Cancer Prev. 2006. 7 (1): 91-4.
In article      PubMed
 
[4]  Heslop HE. Biology and treatment of Epstein-Barr virus-associated non-Hodgkin lymphomas. Hematology Am Soc Hematol Educ Program. 2005: 260-6.
In article      View Article  PubMed
 
[5]  Carbone A, Cesarman E, Spina M, Gloghini A, Schulz TF. HIV-associated lymphomas and gamma-herpesviruses. Blood. 2009. 113 (6): 1213-24.
In article      View Article  PubMed
 
[6]  Olweny CL, Atine I, Kaddu-Mukasa A, Owor R, Andersson-Anvret M, Klein G, et al. Epstein-Barr virus genome studies in Burkitt's and non-Burkitt's lymphomas in Uganda. J Natl Cancer Inst. 1977. 58 (5): 1191-6.
In article      PubMed
 
[7]  Geser A, Lenoir GM, Anvret M, Bornkamm G, Klein G, Williams EH, et al. Epstein-Barr virus markers in a series of Burkitt's lymphomas from the West Nile District, Uganda. Eur J Cancer Clin Oncol. 1983. 19 (10): 1393-404.
In article      View Article
 
[8]  Cool CD, Bitter MA. The malignant lymphomas of Kenya: morphology, immunophenotype, and frequency of Epstein-Barr virus in 73 cases. Hum Pathol. 1997. 28 (9): 1026-33.
In article      View Article
 
[9]  Teras LR, Rollison DE, Pawlita M, Michel A, Brozy J, de Sanjose S, et al. Epstein-Barr virus and risk of non-Hodgkin lymphoma in the cancer prevention study-II and a meta-analysis of serologic studies. Int J Cancer. 2015. 136 (1): 108-16.
In article      View Article  PubMed
 
[10]  Mitarnun W, Pradutkanchana J, Takao S, Saechan V, Suwiwat S, Ishida T. Epstein-barr virus-associated non-Hodgkin's lymphoma of B-cell origin, Hodgkin's disease, acute leukemia, and systemic lupus erythematosus: a serologic and molecular analysis. J Med Assoc Thai. 2002. 85 (5): 552-9.
In article      PubMed
 
[11]  Chabay PA, De Matteo EN, Aversa L, Maglio S, Grinstein S, Preciado MV. Assessment of Epstein-Barr virus association with pediatric non-hodgkin lymphoma in immunocompetent and in immunocompromised patients in Argentina. Arch Pathol Lab Med. 2002. 126 (3): 331-5.
In article      PubMed
 
[12]  Kasprzak A, Spachacz R, Wachowiak J, Stefanska K, Zabel M. Epstein-Barr virus (EBV) infection in B-cell non-Hodgkin's lymphomas in children: virus latency and its correlation with CD21 and CD23 molecules. Folia Histochem Cytobiol. 2007. 45 (3): 169-79.
In article      PubMed
 
[13]  Ishtiaq S, Hassan U, Mushtaq S, Akhtar N. Determination of frequency of epstein-barr virus in non- Hodgkin lymphomas Using EBV latent membrane protein 1 (EBV-LMP1) immunohistochemical staining. Asian Pac J Cancer Prev. 2013. 14 (6): 3963-7.
In article      View Article  PubMed
 
[14]  Brady G, MacArthur GJ, Farrell PJ. Epstein-Barr virus and Burkitt lymphoma. J Clin Pathol. 2007. 60 (12): 1397-402.
In article      PubMed
 
[15]  Tumwine LK, Orem J, Kerchan P, Byarugaba W, Pileri SA. EBV, HHV8 and HIV in B cell non Hodgkin lymphoma in Kampala, Uganda. Infect Agent Cancer. 2010. 5: 12.
In article      View Article  PubMed
 
[16]  Raphael MM, Audouin J, Lamine M, Delecluse HJ, Vuillaume M, Lenoir GM, et al. Immunophenotypic and genotypic analysis of acquired immunodeficiency syndrome-related non Hodgkin's lymphomas. Correlation with histologic features in 36 cases. French Study Group ofPathology for HIV-Associated Tumors. Am J Clin Pathol. 1994. 101 (6): 773-82.
In article      PubMed
 
[17]  Flavell KJ, Murray PG. Hodgkin's disease and the Epstein-Barr virus. Mol Pathol. 2000. 53 (5): 262-9.
In article      View Article  PubMed
 
  • CiteULikeCiteULike
  • MendeleyMendeley
  • StumbleUponStumbleUpon
  • Add to DeliciousDelicious
  • FacebookFacebook
  • TwitterTwitter
  • LinkedInLinkedIn