Dengue virus infection and potential association with acute lymphoblastic leukemia in Egypt: a pilot study

TL;DR

This pilot study explores a potential link between dengue virus infection and acute lymphoblastic leukemia in Egyptian patients.

Contribution

It is the first to suggest a possible association between dengue infection and leukemia in a specific Egyptian population.

Findings

Dengue IgG positivity was significantly higher in pediatric ALL patients compared to controls.

A significant association was found between dengue infection and the BCR-ABL fusion gene in pediatric patients.

No significant difference in short-term outcomes was observed between dengue-positive and dengue-negative patients.

Abstract

Dengue fever is arthropod born disease transmitted by the bite of a mosquito called Aedes aegypti. Some researchers have suggested a link between previous dengue infection and leukemia. The aim of this pilot study is to determine the frequency of dengue infection in acute lymphoblastic leukemia patients (ALL) compared to age and sex matched controls and to find the impact of this infection on the disease outcome.

This is a single center pilot study that included two groups, 30 newly diagnosed pediatric ALL patients and 22 newly diagnosed adult ALL patients that were compared with 50 age and sex matched healthy controls (25 for each group) and 8 pediatric immunosuppressed controls. ELISA was used to detect IgM and IgG antibodies in serum samples at presentation and clinical and laboratory data at admission were collected. Positive and negative dengue patients were followed up for a minimum of six months (hybrid case control –cohort study).

Among pediatric patients who were evaluated for dengue infection by the serological tests, 46.7% (14/30), 8% (2/25) and 0% (0/8) tested positive for IgG in patients, immuno-competent and immunocompromised controls respectively (p value 0.002). There was a significant association between acute dengue infection and BCR-ABL fusion oncogenic gene only in pediatric patients. No statistically significant difference in short term outcomes was observed.

This pilot study provides preliminary data to guide large scale research on the role of dengue infection as a predisposing or exacerbating factor in genetically susceptible children.

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