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Persistent low level Epstein-Barr virus DNAemia in childhood cancer survivors
Shaza S A Mahmoud1, Takashi Fukushima, Takashi Shimizu
1Department of Pediatric Health, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tennodai, Tsukuba, Ibaraki, Japan. shazamahmoud08@gmail.com
Insights
Childhood cancer survivors frequently show persistent Epstein-Barr virus (EBV) DNAemia, particularly those with acute lymphoblastic leukemia and lymphoma, for over five years post-treatment. This finding highlights the need for monitoring EBV status in these young patients.
Area of Science:
- Pediatric Oncology
- Virology
- Immunology
Background:
- Epstein-Barr virus (EBV) status is not well-documented in childhood cancer survivors (CCSs) in long-term remission.
- Understanding EBV dynamics is crucial for managing long-term health in pediatric cancer patients.
Purpose of the Study:
- To evaluate Epstein-Barr virus (EBV) DNA status in children with various malignant diseases after completing cancer treatment.
- To identify potential risk factors or specific cancer types associated with persistent EBV DNAemia in CCSs.
Main Methods:
- Monitored EBV DNA in whole blood samples from 30 pediatric cancer patients using real-time QPCR.
- Reviewed clinical records and laboratory data for patients treated at University of Tsukuba Hospital.
- Included patients with acute lymphoblastic leukemia (ALL), solid tumors, lymphoma, CNS tumors, and acute myeloid leukemia (AML).
Main Results:
- Persistent EBV DNAemia was detected in 20% (6/30) of CCSs.
- Higher rates of persistent EBV DNAemia were observed in acute lymphoblastic leukemia (44.4%) and lymphoma (50%) cases.
- Persistent EBV DNAemia was observed for over 5 years without associated symptoms or diseases.
Conclusions:
- Childhood cancer survivors exhibit persistent EBV DNAemia more frequently than previously recognized.
- Acute lymphoblastic leukemia and lymphoma cases show a higher tendency for persistent EBV DNAemia lasting over 5 years.
- Persistent EBV DNAemia is common in CCSs aged 5-10 years, though the underlying pathophysiology and immunological alterations require further investigation.
Background:
Clinical observation of Epstein-Barr virus (EBV) status has not documented in childhood cancer survivors (CCSs) sustaining long-term remission of malignant diseases. Thus, the aim of this study was to evaluate the EBV status in children with various malignant diseases after they completed their treatments.
Patients And Methods:
Thirty consecutive children with various malignant diseases previously received treatment at the University of Tsukuba Hospital. Nine cases had acute lymphoblastic leukemia (ALL), 10 had solid tumors, 4 had lymphoma, 4 had CNS tumors, and 3 had acute myeloid leukemia (AML). EBV DNA in 328 whole blood samples were monitored by real-time QPCR for all cases after treatment. Clinical records and laboratory data were also reviewed.
Results:
There were 6/30 (20%) cases with continuous detection of EBV DNA while there were 24/30 (80%) cases without continuous EBV DNA. EBV DNAemia was persistently observed in 4/9 (44.4%) cases with ALL and in 2/4 (50%) cases with lymphoma. Persistent EBV DNAemia can be observed for >5 years without any EBV associated symptoms or diseases.
Conclusions:
Childhood cancer survivors have persistent EBV DNAemia more frequently, which is thought to be observed in cases with ALL and lymphoma with higher tendency for >5 years after treatment. Persistent EBV DNAemia is frequent in CCSs aged 5-10 years. Any immunological alteration is speculative in a pathophysiology of persistent EBV DNAemia.
