| Objective To investigate the role of EBV infection in the development,progression,and chromosomal alteration of lymphoma and Myelodysplastic syndromes(MDS),the copy number of EBV in the bone marrow of patients with lymphoma and MDS was examined.Meanwhile,the value of EBV infection in lymphoma immunophenotyping and prognosis of lymphoma and MDS patients was also studied.Methods Bone marrow specimens from 198 patients with lymphoma and MDS were collected as experimental cases,including 14 patients with Hodgkin's lymphoma(HL),136 patients with non-Hodgkin's lymphoma(NHL),and 48 patients with MDS.The bone marrow of 37 healthy people(without any blood system disease and normal bone marrow)served as a control group.The phenol-chloroform-isoamyl alcohol method was used to extract DNA from mononuclear cells in bone marrow.The real-time fluorescence quantitative polymerase chain reaction(FQ-PCR)technique was used to detect EBV-DNA in the bone marrow cells of all samples.Chromosomal specimens were prepared by shortterm culture of cells,and karyotypes were analyzed by R banding technique.Immunophenotypic analysis of NHL patients was performed by flow cytometry to investigate the correlation between T-NHL and B-NHL and EBV infection.Some patients were followed up clinically to further investigate the effects of EBV infection and recurrence and death in patients with lymphoma and MDS.Results EBV-DNA was detected in 76 of 198 patients with lymphoma and MDS,the overall positive rate was 38.4%.EBV-DNA was detected in 2 of 37 controls(5.4%).The positive rate in lymphoma and MDS patients was significantly higher than that in control group(?2=13.8,p < 0.01).The positive rates of EBV were 64.3%(9/14),36.8%(50/136)and 35.4%(17/48)in patients with different hematological malignancies,such as HL,NHL and MDS,respectively.Their positive rates of EBV were also significantly higher than those in the control group(?2= 17.4,p < 0.01;?2 = 12.1,p < 0.01;?2 = 10.7,p < 0.01),and there was no difference among the three diseases(p > 0.05).Flow cytometry typing showed 110 cases of B-NHL,36.4% of EBV,26 cases of T-NHL and 38.5% of EBV.There was no difference in EBV-positive rate between B-NHL and T-NHL(?2=0.04,p>0.05).Cytogenetic analysis showed that in NHL and MDS,there were 10 cases with chromosomal abnormalities and EBV-positive respectively,12 cases with chromosomal abnormalities and 15 cases with EBV-negative respectively.Chromosomal abnormalities in NHL and MDS had no significant correlation with EBV infection(?2 = 0.96,p > 0.05;?2= 0.47,p > 0.05).The clinical followup showed that the recurrence rate and mortality rate of EBV-positive group and EBVnegative group were 56.1%(23/41),31.7%(20/63),24.4%(10/41)and 3.2%(2/63)respectively within 2 years(p < 0.05).Compared with EBV-negative,EBV-positive has higher recurrence rate and mortality rate.In addition,8 out of 11 patients with acute leukemia(72.7%)were EBV-positive and 3(27.3%)were EBV-negative.The difference between them was significant(?2=6.70,p < 0.05),indicating that there was a correlation between the progression of MDS to acute leukemia and EBV infection.Conclusion EBV infection may be related to the occurrence and development of lymphoma and MDS.EBV may be involved in the transformation of MDS to acute leukemia.EBV positive patients have high recurrence rate,high mortality and poor prognosis.EBV infection may have no effect on NHL immunotyping. |
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