title: Clinical outcome of elderly patients with Epstein-Barr virus positive diffuse large B-cell lymphoma treated with a combination of rituximab and CHOP chemotherapy.
abstract: Several studies have suggested the possibility of a prognostic relationship between Epstein-Barr virus (EBV) and diffuse large B-cell lymphoma (DLBCL). The clinical outcome of EBV-associated DLBCL is not clear, especially since the introduction of rituximab. We retrospectively analyzed 222 elderly patients (≥50 years) with DLBCL who received R-CHOP chemotherapy and evaluated the state of EBV-encoded RNA-1 (EBER). Eighteen cases (8.1%) were EBER-positive (+). After a median of six cycles of R-CHOP chemotherapy, the response rate (≥partial response) was 72.2% (13/18) in the EBV (+) patients and 90.2% (184/204) in the EBV (-) DLBCL patients (P = 0.021). Four of 18 (22.2%) EBV (+) DLBCL patients received two or fewer cycles of R-CHOP chemotherapy. R-CHOP chemotherapy was also interrupted early more frequently compared with the EBV (-) group (2.5%) (P = 0.00). At a median follow-up of 32.8 months, there was no significant difference in the overall survival between the groups (P = 0.627). The EBV (+) DLBCL patients with early interruption of R-CHOP chemotherapy showed a trend toward a high EBV-DNA titer (≥1,000 copies/mL) (P = 0.091). The results suggest that the EBV (+) tumoral status of elderly DLBCL patients who undergo R-CHOP chemotherapy does not predict their survival but that their EBV status may contribute to the early interruption of R-CHOP chemotherapy.
authors.affiliation: Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Jeollanamdo, Republic of Korea.
authors.forename: Jae-Sook
authors.initials: JS
authors.lastname: Ahn
authors.forename: Deok-Hwan
authors.initials: DH
authors.lastname: Yang
authors.forename: Yoo
authors.initials: Y
authors.lastname: Duk Choi
authors.forename: Sung-Hoon
authors.initials: SH
authors.lastname: Jung
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Yhim
authors.forename: Jae-Yong
authors.initials: JY
authors.lastname: Kwak
authors.forename: Ho
authors.initials: H
authors.lastname: Sung Park
authors.forename: Myung-Geun
authors.initials: MG
authors.lastname: Shin
authors.forename: Yeo-Kyeoung
authors.initials: YK
authors.lastname: Kim
authors.forename: Hyeoung-Joon
authors.initials: HJ
authors.lastname: Kim
authors.forename: Je-Jung
authors.initials: JJ
authors.lastname: Lee
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D004279:DNA, Viral / Q000302:isolation & purification*; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D004854:Herpesvirus 4, Human / Q000254:growth & development*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000188:drug therapy* / Q000401:mortality / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011241:Prednisone / Q000627:therapeutic use; D012189:Retrospective Studies; D000069283:Rituximab; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D004279:DNA, Viral; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone