African Burkitt's lymphoma: a new perspective

High titres of antibody to Epstein-Barr virus (EBV) late genes identify ind ividuals at risk of developing endemic Burkitt's lymphoma (eBL). Viral lyri c cycle early and intermediate-early gene expression in BL is associated wi th a favourable tumour response to chemotherapy. Our study investigated whe ther serological data identifying antibody expression to zta, a viral funct ion that activates lyric-cycle gene expression, correlate with expression o f its gene in rumours, and could have prognostic value. Studies on 10 Malaw ian patients, with presumed BL on clinical grounds, showed good correlation s, suggesting that serum antibody responses might predict treatment respons iveness. The results with 1 patient were particularly striking. When admitt ed in January 1998, prognosis was poor as he was unable to walk, and had tu mour cells, characteristic of stage IV disease, in his bone marrow. Laborat ory investigations showed particularly high levels both of serum zta antibo dies and of gene expression in his tumour. Follow-up confirmed him alive 6 months after hospital discharge. Among the EBV-positive cases, 2 were ultim ately diagnosed as rhabdomyosarcoma, a tumour not previously associated wit h this virus. The findings from this small study, if confirmed, should have value for future BL management in resource-poor parts of the world.