Comprehensive Analysis of Immunophenotyping and Molecular Detection of Epstein-Barr virus Infection Associated with Diffuse Large B-Cell Lymphoma in Iraqi Patients

Alhiti, Mustafa A.J.; Al-Ahmer, Saife D.; Naji, Alaadin S.

doi:10.21608/ejmm.2025.421068.1857

Comprehensive Analysis of Immunophenotyping and Molecular Detection of Epstein-Barr virus Infection Associated with Diffuse Large B-Cell Lymphoma in Iraqi Patients

Document Type : New and original researches in the field of Microbiology.

Authors

¹ Institute of Genetic Engineering and Biotechnology for Postgraduate Studies, University of Baghdad, Baghdad, Iraq

² Institute of Genetic Engineering and Biotechnology for Postgraduate studies, University of Baghdad, Baghdad, Iraq

³ Internal Medicine and Clinical Hematology Department, College of Medicine, University of Baghdad, Baghdad, Iraq

10.21608/ejmm.2025.421068.1857

Abstract

Background: Epstein-Barr virus (EBV) is associated with diffuse large B-cell lymphoma (DLBCL), a common and aggressive non-Hodgkin lymphoma. Detailed serological, molecular, and immunophenotypic analyses are essential for understanding its pathogenesis and prognosis. Objective: This study aimed to characterize EBV infection and immunophenotypic markers in Iraqi DLBCL patients, assessing their diagnostic and prognostic relevance across subgroups. Methods: A cohort of 110 participants (70 DLBCL patients: 24 pre-treated, 24 treated, 22 relapse; 40 healthy controls) was evaluated. EBV DNA load was quantified via RT-PCR. Serological markers and immunophenotypic markers levels were analyzed using ELISA. Statistical significance was determined via ANOVA (p<0.05). Results: EBV viral loads showed highly significant rise in treated (7971±9985) and relapse groups (12327±6949) (p<0.0001). Serological markers showed highly significantly higher in DLBCL subgroups for Anti-VCA IgG (pre-treated) (90.84±30.76) (p<0.0001), and Anti-ZEBRA (IgM) showed relapse: (44.72±10.70) (p=0.0002). The immunophenotyping results of DLBCL were significantly higher in subgroups for BCL-2 in treated group (31.50±7.24) (p=0.0206), while BCL-6 showed in treated group (118.0±23.32) (p=0.0179), while CD3 were in pre-treated group (1.40±0.27) (p=0.0435), CD10 showed in treated group (2.66±0.89) (p=0.0036), therefore CD20 showed in relapse group (1.30±0.22) (p=0.0003), while cyclin D1 showed in pre-treated group (1.41±0.26) (p=0.0492), while MUM-1 showed in pre-treated group (117.3±33.68) (p=0.0017), whether c-MYC binding protein in relapse group (0.25±0.12) (p=0.0020). Conclusions: EBV reactivation and elevated viral loads are linked to the progression and relapse of DLBCL in Iraqi patients. Biomarkers: BCL-6, MUM-1, and c-MYC binding protein highlight EBV’s role in tumor aggressiveness and help to guide diagnosis.

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