Effect of positive bone marrow EBV in situ hybridization in staging and survival of localized extranodal natural killer/T-cell lymphoma, nasal-type.
OBJECTIVE
The aim of the study was to determine the effect of EBV-encoded RNA-1 in situ hybridization (EBER-1 ISH) in bone marrow specimens on survival outcome in patients with clinical stage I/II natural killer/T-cell lymphoma.


METHODS
We systematically did EBER-1 ISH on 182 archival bone marrow tissues from 91 patients who were diagnosed of stage I/II natural killer/T-cell lymphoma and analyzed the correlation between bone marrow EBER-1 ISH status and survival. We defined minimal bone marrow involvement and definite bone marrow involvement to distinguish the subgroups who revealed EBV-positive cells from normal marrow by EBER-1 ISH from those who showed typical neoplastic cells in bone marrow biopsies.


RESULTS
In total, 17 of the 91 (18.7%) patients showed positivity for EBER-1 ISH at least in one of the bilateral bone marrow biopsies with 14 minimal bone marrow involvements and 3 definite bone marrow involvements. Patients with positive bone marrow EBER-1 ISH showed significantly poorer overall survival than those who were negative for bone marrow EBER-1 ISH (median survival, 16.1 months versus not reached; P = 0.045).


CONCLUSIONS
Considering a high proportion of stage I/II patients (15.4%) with minimal in bone marrow specimens, bone marrow EBER-1 ISH should be routinely done in all patients with localized disease for more accurate staging.
Lee
Jeeyun
J
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Suh
Cheolwon
C
Huh
Jooryung
J
Jun
Hyun Jung
HJ
Kim
Kihyun
K
Jung
Chulwon
C
Park
Keunchil
K
Park
Yeon Hee
YH
Ko
Young Hyeh
YH
Kim
Won Seog
WS
D000368:Aged; D001853:Bone Marrow / Q000821:virology*; D001854:Bone Marrow Cells / Q000378:metabolism; D017252:CD3 Complex / Q000096:biosynthesis; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D005260:Female; D004854:Herpesvirus 4, Human / Q000378:metabolism*; D006801:Humans; D017403:In Situ Hybridization; D007694:Killer Cells, Natural / Q000378:metabolism / Q000821:virology; D016399:Lymphoma, T-Cell / Q000401:mortality* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000401:mortality* / Q000821:virology*; D009367:Neoplasm Staging / Q000379:methods*
D017252:CD3 Complex