title: Prognostic significance of Epstein-Barr virus in nodal peripheral T-cell lymphoma, unspecified: A Groupe d'Etude des Lymphomes de l'Adulte (GELA) study.
abstract: Peripheral T-cell lymphomas (PTCLs) are rare and have a dismal prognosis. The most frequent subtype is PTCL, unspecified. Epstein-Barr virus (EBV) has been detected in around 40% of cases, but its prognostic significance is not fully established. Lymph node samples from 110 patients with PTCL, unspecified included in LNH87 and LNH93 trials were available. EBV status was studied by EBV-encoded small RNA in situ hybridization (EBER-ISH). EBER-ISH showed positive cells in 45 (41%) of 110 patients. Pretreatment characteristics were comparable between positive and negative cases, except for male sex (80% versus 60%, respectively, P = .02). Only 50% of patients achieved complete remission with a 5-year event-free survival (EFS) and overall survival (OS) of 21% and 30%, respectively. EBER-ISH positivity was the sole factor linked with worse EFS, with a 5-year probability of 11% for positive patients. In univariate analysis, factors affecting OS were EBER-ISH positivity, high LDH level, and age older than 60 years. In multivariate analysis, EBER-ISH was associated with a worse OS in the elderly population. Time-dependent analysis showed that the negative impact of EBV was essentially seen in the first 2 years following diagnosis. These results warrant further studies regarding pathogenesis and specific treatment approaches for EBV-associated PTCL patients.
authors.affiliation: Department of Hematology, Institut National de la Santé et de la Recherche Médicale (INSERM) U617 Hôpital Henri Mondor, Créteil, France.
authors.forename: Jehan
authors.initials: J
authors.lastname: Dupuis
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Emile
authors.forename: Nicolas
authors.initials: N
authors.lastname: Mounier
authors.forename: Christian
authors.initials: C
authors.lastname: Gisselbrecht
authors.forename: Nadine
authors.initials: N
authors.lastname: Martin-Garcia
authors.forename: Tony
authors.initials: T
authors.lastname: Petrella
authors.forename: Reda
authors.initials: R
authors.lastname: Bouabdallah
authors.forename: Françoise
authors.initials: F
authors.lastname: Berger
authors.forename: Alain
authors.initials: A
authors.lastname: Delmer
authors.forename: Bertrand
authors.initials: B
authors.lastname: Coiffier
authors.forename: Félix
authors.initials: F
authors.lastname: Reyes
authors.forename: Philippe
authors.initials: P
authors.lastname: Gaulard
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D018572:Disease-Free Survival; D020031:Epstein-Barr Virus Infections / Q000188:drug therapy / Q000235:genetics / Q000401:mortality* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D004854:Herpesvirus 4, Human / Q000235:genetics; D006801:Humans; D017404:In Situ Hybridization, Fluorescence / Q000379:methods; D016411:Lymphoma, T-Cell, Peripheral / Q000188:drug therapy / Q000235:genetics / Q000401:mortality* / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012367:RNA, Viral / Q000235:genetics; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D012367:RNA, Viral