Prognostic significance of Epstein-Barr virus DNA detection in pretreatment serum in diffuse large B-cell lymphoma.
It is still a matter of debate whether detection of Epstein-Barr virus (EBV) DNA in pretreatment serum has clinical implications for diffuse large B-cell lymphoma. For this study, we measured EBV DNA load in pretreatment serum from 127 diffuse large B-cell lymphoma patients without any underlying immunodeficiency to evaluate its effects on clinical manifestations and prognosis. Anthracycline-based chemotherapy in combination with rituximab was given as initial therapy for 119 patients (94%). Epstein-Barr virus DNA was detected in 15 patients (12%), who were older (P = 0.005) and tended to be at a more advanced disease stage (P = 0.053). They showed significantly worse progression-free survival (PFS) and overall survival (OS) than other patients (P < 0.001 each). This effect remained significant (P = 0.004 and P = 0.027, respectively) after adjustment for age, lactate dehydrogenase, performance status, stage, and extranodal sites. The status of EBV-encoded small RNA in situ hybridization was known for 123 patients; 6 of 8 positive patients (75%) and 9 of 115 negative patients (8%) had detectable EBV DNA in pretreatment serum. While patients positive for EBV-encoded small RNA had significantly worse PFS and OS than negative patients (P = 0.001 and P = 0.029, respectively), EBV DNA detection in pretreatment serum was associated with poorer PFS and OS even for the 115 patients negative for EBV-encoded small RNA (P < 0.001 each). These findings suggest that EBV DNA detection in pretreatment serum may have an adverse prognostic impact for patients with diffuse large B-cell lymphoma.
Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan.
Akinao
A
Okamoto
Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan.
Masamitsu
M
Yanada
Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan.
Hiroki
H
Miura
Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan.
Yoko
Y
Inaguma
Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan.
Masutaka
M
Tokuda
Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan.
Satoko
S
Morishima
Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan.
Tadaharu
T
Kanie
Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan.
Yukiya
Y
Yamamoto
Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan.
Shuichi
S
Mizuta
Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan.
Yoshiki
Y
Akatsuka
Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan.
Tetsushi
T
Yoshikawa
Department of Pathology, Fujita Health University School of Medicine, Toyoake, Japan.
Yoshikazu
Y
Mizoguchi
Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan.
Shigeo
S
Nakamura
Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan.
Masataka
M
Okamoto
Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan.
Nobuhiko
N
Emi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood*; D004279:DNA, Viral / Q000097:blood*; D018572:Disease-Free Survival; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D005260:Female; D004854:Herpesvirus 4, Human; D006801:Humans; D017403:In Situ Hybridization; D053208:Kaplan-Meier Estimate; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000401:mortality / Q000821:virology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D004279:DNA, Viral
Diffuse large B-cell lymphoma; EBER; EBV DNA load; Epstein-Barr virus (EBV)