title: Epstein-Barr virus-associated diffuse large B-cell lymphoma: diagnosis, difficulties and therapeutic options.
abstract: Epstein Barr Virus (EBV)-positive diffuse large B cell lymphoma (DLBCL) most frequently affects elderly patients, without previous immunosuppression, with frequent extra-nodal involvement and whose disease runs an aggressive clinical course with high International Prognostic Index (IPI) scores. Various EBV-related transforming mechanisms, much favored by immunosenescence, have been described, including activation of the NFKB transcriptional program. Elderly patients show poor survival after treatment with conventional CHOP regimens, even after addition of Rituximab. Younger patients, however, have a better outcome with a similar prognosis to EBV-negative DLBCL cases. New therapeutic strategies, including treatments targeting EBV, new drugs directed against specific pathways constitutively activated in these lymphomas, and new specific conjugate antibodies against molecules usually expressed in the tumor cells, such as CD30, are described.
authors.affiliation: a Services of Haematology and Pathology , Hospital Universitario Marques de Valdecilla , Santander , Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Battle-Lopez
authors.affiliation: a Services of Haematology and Pathology , Hospital Universitario Marques de Valdecilla , Santander , Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Gonzalez de Villambrosia
authors.affiliation: a Services of Haematology and Pathology , Hospital Universitario Marques de Valdecilla , Santander , Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Nuñez
authors.affiliation: a Services of Haematology and Pathology , Hospital Universitario Marques de Valdecilla , Santander , Spain.
authors.forename: Maria-Luisa
authors.initials: ML
authors.lastname: Cagigal
authors.affiliation: a Services of Haematology and Pathology , Hospital Universitario Marques de Valdecilla , Santander , Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Montes-Moreno
authors.affiliation: a Services of Haematology and Pathology , Hospital Universitario Marques de Valdecilla , Santander , Spain.
authors.forename: Eulogio
authors.initials: E
authors.lastname: Conde
authors.affiliation: a Services of Haematology and Pathology , Hospital Universitario Marques de Valdecilla , Santander , Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Piris
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000473:pathology / Q000821:virology; D003937:Diagnosis, Differential; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D004854:Herpesvirus 4, Human / Q000187:drug effects / Q000472:pathogenicity*; D054884:Host-Pathogen Interactions; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D017730:Ki-1 Antigen / Q000097:blood; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy* / Q000821:virology; D008297:Male; D058990:Molecular Targeted Therapy / Q000379:methods; D011379:Prognosis
chemical_list: D000998:Antiviral Agents; D017730:Ki-1 Antigen
keywords: EBV; NFKB; elderly; immunosenescence; lymphoma