title: Impact of the Epstein-Barr virus positivity on Hodgkin's lymphoma in a large cohort from a single institute in Korea.
abstract: Epstein-Barr virus (EBV) is considered a prognostic marker in Hodgkin lymphoma (HL) patients, but previous studies have yielded mixed findings because of the confounding effects of factors including age. We examined the prognostic impact of EBV status on 159 patients with HL. The median age at diagnosis was 32 years (range, 4-77 years). The median follow-up time was 5.83 years (range, 0.33-19.69 years). Tumor cell EBV status was positive in 34.5 %. EBV-positive HL was associated with age of ≥ 25 years, male gender, B symptoms, advanced stage, high-risk IPS, nonnodular sclerosis subtype, and treatment with chemotherapy only (P < 0.05). The 5-year disease-specific survival (DSS) rates were 94.1 and 76.4 % for the EBV-negative and EBV-positive HL, respectively, (P < 0.001). On univariate analysis, event-free survival, DSS, and overall survival (OS) were significantly associated with age 40 years or older, B symptoms, and high-risk international prognostic score (≥ 4). On multivariate analysis, EBV positivity was found to be a significant prognostic factor for DSS, particularly in adults 25 years or older. Subgroup analysis showed significant association of EBV-positive HL with poorer DSS and OS in adults 25 years or older with advanced stage disease. In the present series of HL patients, the presence of EBV in tumor cells is associated with adverse prognostic factors. EBV-positive HL is significantly associated with poorer DSS in all age groups.
authors.affiliation: Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Seoul, 138-736, South Korea.
authors.forename: Young Wha
authors.initials: YW
authors.lastname: Koh
authors.forename: Dok Hyun
authors.initials: DH
authors.lastname: Yoon
authors.forename: Cheolwon
authors.initials: C
authors.lastname: Suh
authors.forename: Jooryung
authors.initials: J
authors.lastname: Huh
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology*; D005500:Follow-Up Studies; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006689:Hodgkin Disease / Q000145:classification / Q000188:drug therapy / Q000453:epidemiology* / Q000532:radiotherapy / Q000821:virology; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D011379:Prognosis; D012367:RNA, Viral / Q000032:analysis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C099537:Epstein-Barr virus encoded RNA 1; D012367:RNA, Viral