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Epstein-Barr Virus in the Bone Marrow of Patients with Aplastic Anemia
- Bruce Baranski, MD;
- Gary Armstrong, BSMT;
- John T. Truman, MD;
- Gerald V. Quinnan, Jr, MD;
- Stephen E. Straus, MD; and
- Neal S. Young, MD
Abstract
Study Objective: To determine whether Epstein-Barr virus is present in the bone marrow of patients with aplastic anemia.
Design: Assay of fresh and fixed bone marrow specimens for Epstein-Barr virus using immunofluorescence for nuclear antigen, Southern analysis with an Epstein-Barr virus specific probe, and in-situ hybridization.
Setting: Governmental medical referral center.
Patients: Five patients were studied prospectively: three who previously had infectious mononucleosis, one with a recent viral pneumonitis, and one who was asymptomatic. Stored DNA samples from other patients with aplastic anemia were also screened.
Measurements and Main Results: Epstein-Barr virus DNA and protein were detected in the bone marrow of 5 patients studied prospectively and in 1 of 40 patients studied retrospectively. As estimated by in-situ hybridization, about 3% to 5% of marrow cells were infected with virus in those patients who had not received acyclovir. In contrast, Epstein-Barr virus DNA was not detected in peripheral blood DNA of these patients, nor were Epstein-Barr virus proteins or DNA found in the bone marrow of normal donors, patients with other hematologic diseases, or in 1 patient with acute infectious mononucleosis. Analysis of DNA fragments by hybridization with Epstein-Barr virus probes showed a pattern dissimilar to the type of Epstein-Barr virus usually associated with infectious mononucleosis.
Conclusions: Aplastic anemia may be associated with Epstein-Barr virus more commonly than suspected by history. Localization of the virus in the bone marrow supports a causative role for Epstein-Barr virus in bone marrow failure.
Article and Author Information
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From the National Institutes of Health, Bethesda, Maryland. For current author addresses, see end of text.
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Requests for Reprints: Neal S. Young, MD, Building 10, Room 7C103, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892.
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Current Author Addresses: Dr. Baranski: Room H4/540 Clinical Sciences Center, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792.
Mr. Armstrong: Building 29A, HFB-5000, 8800 Rockville Pike, Bethesda, MD 20892.
Dr. Truman: Department of Pediatrics, Morristown Memorial Hospital, 100 Madison Avenue, Morristown, NJ 07960.
Dr. Quinnan: Building 29, HFB-2, 8800 Rockville Pike, Bethesda, MD 20892.
Dr. Straus: Building 10, Room 11N-113, 9000 Rockville Pike, Bethesda, MD 20892.
Dr. Young: Building 10, Room 7C103, 9000 Rockville Pike, Bethesda,
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