title: Epstein-Barr virus and cytomegalovirus infections and their clinical relevance in Egyptian leukemic pediatric patients.
abstract: Epstein-Barr virus (EBV) and human cytomegalovirus (CMV) infections are environmental risk factors affecting the outcome of cancer due to an impairment in the cell-mediated immunity. Therefore, this study aimed to detect the frequency of EBV and CMV DNA and their association with clinical characteristics and outcome of pediatric leukemic patients.
  
  
  
  Samples of 50 immunocompromised pediatric leukemic patients and 30 apparently healthy children were subjected to the amplification of EBV DNA by one version of PCR targeting the Bam H1 W region of the genomic region of EBV, and the amplification of CMV DNA by targeting the CMV UL97 genomic region by a second round PCR. All investigations were performed on WBCs and sera. Results were correlated with the clinical and laboratory characteristics of the disease, and with overall survival.
  
  
  
  EBV and CMV DNA were detected in 20 and 54% of leukemic patients, respectively. Nine out of ten patients with EBV DNA (90%) were positive for CMV DNA in their sera. The presence of EBV DNA or CMV DNA was associated with neutropenia and a low total leukocyte count (TLC) (p = 0.02, 0.03, respectively). The presence of severe CMV disease, longer duration of febrile neutropenia, neutropenia, lymphopenia, thrombocytopenia and the presence of EBV DNA in patients' sera were significantly associated with worse overall survival.
  
  
  
  The detection of CMV disease and EBV DNA is relatively common in leukemic children and is significantly associated with a decline in the overall survival.
authors.affiliation: Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Fom El-Khalig, Cairo, 11796, Egypt. samaly183@yahoo.com.
authors.forename: Samah Aly
authors.initials: SA
authors.lastname: Loutfy
authors.affiliation: Microbiology and Immunology Department, Faculty of Pharmacy (Girls), Al Azhar University, Nasr City, Egypt.
authors.forename: Maha A
authors.initials: MA
authors.lastname: Abo-Shadi
authors.affiliation: Pediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Fawzy
authors.affiliation: Clinical Oncology Department, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: El-Wakil
authors.affiliation: Microbiology and Immunology Department, Faculty of Pharmacy (Girls), Al Azhar University, Nasr City, Egypt.
authors.forename: Shimaa A
authors.initials: SA
authors.lastname: Metwally
authors.affiliation: Cancer Epidemiology and Biostatistics Department, National Cancer Institute, Cairo University, Cairo, Egypt.
authors.forename: Manar M
authors.initials: MM
authors.lastname: Moneer
authors.affiliation: Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Fom El-Khalig, Cairo, 11796, Egypt.
authors.forename: Nasra F Abdel
authors.initials: NF
authors.lastname: Fattah
authors.affiliation: Chemistry of natural and microbial products Department Pharmaceutical Industries Division, National Research Center, Giza, Egypt.
authors.forename: Sara
authors.initials: S
authors.lastname: Kassem
authors.affiliation: Faculty of Medicine, Al Azhar University, Nasr City, Egypt.|Medical Research Group of Egypt, Cairo, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Elgebaly
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000453:epidemiology* / Q000473:pathology; D004279:DNA, Viral / Q000097:blood; D004534:Egypt / Q000453:epidemiology; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D007938:Leukemia / Q000150:complications*; D008297:Male; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D016019:Survival Analysis
chemical_list: D004279:DNA, Viral
keywords: CMV; EBV; PCR; Pediatric leukemia; Survival