The impact of Epstein-Barr virus status on clinical outcome in diffuse large B-cell lymphoma.
To define prognostic impact of Epstein-Barr virus (EBV) infection in diffuse large B-cell lymphoma (DLBCL), we investigated EBV status in patients with DLBCL. In all, 380 slides from paraffin-embedded tissue were available for analysis by EBV-encoded RNA-1 (EBER) in situ hybridization, and 34 cases (9.0%) were identified as EBER-positive. EBER positivity was significantly associated with age greater than 60 years (P = .005), more advanced stage (P < .001), more than one extranodal involvement (P = .009), higher International Prognostic Index (IPI) risk group (P = .015), presence of B symptom (P = .004), and poorer outcome to initial treatment (P = .006). The EBER(+) patients with DLBCL demonstrated substantially poorer overall survival (EBER(+) vs EBER(-) 35.8 months [95% confidence interval (CI), 0-114.1 months] vs not reached, P = .026) and progression-free survival (EBER(+) vs EBER(-) 12.8 months [95% CI, 0-31.8 months] vs 35.8 months [95% CI, 0-114.1 months], respectively (P = .018). In nongerminal center B-cell-like subtype, EBER in situ hybridization positivity retained its statistical significance at the multivariate level (P = .045). Nongerminal center B-cell-like patients with DLBCL with EBER positivity showed substantially poorer overall survival with 2.9-fold (95% CI, 1.1-8.1) risk for death. Taken together, DLBCL patients with EBER in situ hybridization+ pursued more rapidly deteriorating clinical course with poorer treatment response, survival, and progression-free survival.
Park
Sarah
S
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong Kangnam-ku, Seoul 135-710, Korea.
Lee
Jeeyun
J
Ko
Young Hyeh
YH
Han
Arum
A
Jun
Hyun Jung
HJ
Lee
Sang Chul
SC
Hwang
In Gyu
IG
Park
Yeon Hee
YH
Ahn
Jin Seok
JS
Jung
Chul Won
CW
Kim
Kihyun
K
Ahn
Yong Chan
YC
Kang
Won Ki
WK
Park
Keunchil
K
Kim
Won Seog
WS
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001402:B-Lymphocytes / Q000378:metabolism / Q000473:pathology / Q000821:virology; D018572:Disease-Free Survival; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D005260:Female; D004854:Herpesvirus 4, Human / Q000378:metabolism; D006801:Humans; D017403:In Situ Hybridization; D016393:Lymphoma, B-Cell / Q000150:complications / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000378:metabolism*; D012307:Risk Factors; D015996:Survival Rate
C099537:Epstein-Barr virus encoded RNA 1; D012367:RNA, Viral