Elevated blood MxA protein levels in children with newly diagnosed B-ALL: A prospective case-control study

Abstract

Background/Aim: Although leukemia is thought to be triggered or initiated by viral infections, it is not clear which viruses are the causative agents for which stage of the disease. Previous studies have shown that the MxA protein is expressed from blood mononuclear cells in reply to inducement of type I interferons in viral infections. Viral infections may trigger childhood B-cell acute lymphoblastic leukemia (B-ALL), and the hypothesis of this study was the detection of the presence of viral infection by measuring MxA expression in blood mononuclear cells of recently diagnosed pediatric B-ALL patients as a surrogate viral marker. Methods: This study consisted two groups; the study group consisted of 30 newly diagnosed B-ALL and the control group consisted of 29 healthy asymptomatic children of similar age. Proven bacterial infection and COVID-19 PCR positivity were exclusion criteria. Bacterial culture of peripheral blood, complete blood count, plasma CRP levels and whole blood MxA levels detected by ELISA (Enzyme-Linked ImmunoSorbent Assay) method were taken. Results: The patients’ mean age was 7.42 years in the leukemia group (previously mentioned as study group) and 7.25 years in the control group. Routine serologic studies for newly diagnosed leukemia patients (CMV, EBV VCA and Hepatitis B IgM, anti-HCV and anti-HIV) were negative in all patients without any bacterial infection detected. The MxA levels were found significantly higher in children with B-ALL than in control group (5.84 (2.18-199.38) and 2.45 (1.17-88.65) ngr/ml, respectively, with P<0.001). CRP levels were significantly elevated in children with B-ALL than the control group (27.40 (2.60-133.40) and 0.60 (0.12-4.90) mgr/L, respectively, with P<0.001). Conclusion: Our study demonstrates that blood MxA levels are increased in children with newly diagnosed B-ALL when compared to healthy asymptomatic children. This study is the first in literature in testing MxA levels in children with B-ALL. This finding may underline the triggering effect of viral infections in the onset of leukemia

Keywords

• MxA
• Blood
• Acute Lymphoblastic Leukemia
• Children

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