Epstein-Barr virus in monitoring the response to therapy of acquired immunodeficiency syndrome-related primary central nervous system lymphoma.
To evaluate the value of Epstein-Barr virus DNA (EBV-DNA) assay in cerebrospinal fluid (CSF) for monitoring the response to treatment in acquired immunodeficiency syndrome-related primary central nervous system lymphoma (AIDS-PCNSL), 9 human immunodeficiency virus-infected patients with biopsy-proven AIDS-PCNSL who underwent multimodal therapy were investigated for EBV-DNA detection in CSF by semiquantitative nested polymerase chain reaction (PCR). Tumoral tissue expression of bcl-6 oncogene protein and of EBV-encoded latent membrane protein (LMP-1) was also investigated. The 2 patients who had a response to chemotherapy showed a reduction of mean EBV-DNA concentration values after chemotherapy and displayed a large noncleaved morphology and a BCL-6+/LMP-1- phenotype. Conversely, the 4 patients with progressive disease after chemotherapy showed increasing mean values of EBV-DNA and displayed an immunoblastic morphology and a BCL-6-/LMP-1+ phenotype. No significant changes were observed for patients with stable disease. EBV-DNA burden reduction was significantly associated with prolonged survival. These results suggest that EBV-DNA monitoring might be helpful in predicting response to chemotherapy and in segregating distinct biological and prognostic categories of AIDS-PCNSL.
Antinori
A
A
Department of Infectious Diseases, Catholic University, Rome, Italy.
Cingolani
A
A
De Luca
A
A
Gaidano
G
G
Ammassari
A
A
Larocca
L M
LM
Ortona
L
L
D000704:Analysis of Variance; D016543:Central Nervous System Neoplasms / Q000401:mortality / Q000628:therapy / Q000821:virology*; D003131:Combined Modality Therapy; D004279:DNA, Viral / Q000032:analysis; D018450:Disease Progression; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000401:mortality / Q000628:therapy / Q000821:virology*; D016019:Survival Analysis; D019562:Viral Load