Indian Journal of Pathology and Microbiology

: 2012  |  Volume : 55  |  Issue : 2  |  Page : 266--267

The association of Epstein-Barr virus infection with multiple myeloma

Gulfaraz Khan 
 Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates

Correspondence Address:
Gulfaraz Khan
Department of Microbiology and Immunology,Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, PO Box 17666
United Arab Emirates

How to cite this article:
Khan G. The association of Epstein-Barr virus infection with multiple myeloma.Indian J Pathol Microbiol 2012;55:266-267

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Khan G. The association of Epstein-Barr virus infection with multiple myeloma. Indian J Pathol Microbiol [serial online] 2012 [cited 2020 May 25 ];55:266-267
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We read with interest the recent article by Sadeghian et al. published in the last issue of this journal.[1] The etiology of multiple myeloma (MM) is poorly understood. A number of viruses have been implicated, but the findings have been controversial. The study by Sadeghian et al. is yet another report exploring the possibility of a viral involvement in the pathogenesis of this malignancy. The authors examined if Epstein-Barr virus (EBV) was associated with MM. They found 10/30 MM patients and 3/30 controls to be EBV positive by polymerase chain reaction (PCR). The authors concluded that EBV is associated with MM.

EBV is a B-cell lymphotropic member of the herpesviridae family. It is arguably one of the best studied human oncogenic viruses. Although the virus selectively infects B-cells using CD21/C3d receptor, the virus has been linked to the pathogenesis of a number of human malignancies of both lymphoid and epithelial origin, including Burkitt's lymphoma, nasphopharyngeal carcinoma, and post-transplant lymphomas.[2] However, the mechanism(s) of EBV involvement in the pathogenesis of many of these malignancies is not fully understood. In recent years, the demonstration of EBV genome[3] and EBV gene expression[4] at the cellular level have become the 'gold standards' in studies aimed at investigating a role for this virus in the pathogenesis of human malignancies. Since EBV is ubiquitous in the healthy population, with over 90% of people seropositive worldwide, its mere detection cannot be simply equated with disease. In this context, the study by Sadeghian et al. needs to be interpreted with caution. Using PCR, the authors reported the detection of EBV in 10/30 MM and 3/30 controls. In order to imply an etiological role for EBV in the pathogenesis of MM, the authors should have performed EBV encoded RNA (EBER)-in situ hybridization and immunohistochemistry to show that the virus is present in the malignant cells and is transcriptionally active. In the absence of such data, the association between EBV and MM may be purely casual. Indeed, we have recently shown that in breast cancer, another malignancy in which EBV has been implicated, the virus can be detected in approximately 50% of the cases, but not in the malignant cells.[5] Rather the virus is localized to infiltrating inflammatory lymphocytes and therefore unlikely to be directly involved in the disease process [Figure 1]. Using PCR for the detection of EBV, positivity can be incorrectly interpreted to mean that the virus is associated with the disease process and this should be avoided.{Figure 1}


This work was support by a grant from the FMHS, UAEU.


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2Kieff E, Rickinson AB. Epstein-Barr Virus and its Replication. In: Knipe DM, Howley PM, editors. Fields Virology. Philadelphia: Wolters Kluwer/Lippincott; 2007. p. 2634-54.
3Khan G, Coates PJ, Kangro HO, Slavin G. Epstein Barr virus (EBV) encoded small RNAs: Targets for detection by in situ hybridisation with oligonucleotide probes. J Clin Pathol 1992;45:616-20.
4Young LS, Deacon EM, Rowe M, Crocker J, Herbst H, Niedobitek G, et al. Epstein-Barr virus latent genes in tumour cells of Hodgkin's disease. Lancet 1991;337:1617.
5Khan G, Philip PS, Al Ashari M, Houcinat Y, Daoud S. Localization of Epstein-Barr virus to infiltrating lymphocytes in breast carcinomas and not malignant cells. Exp Mol Pathol 2011;91:466-70.