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Blood, 1 October 2005, Vol. 106, No. 7, pp. 2444-2451.
Prepublished online as a Blood First Edition Paper on June 7, 2005; DOI 10.1182/blood-2004-09-3759.
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NEOPLASIA
Impact of tumor Epstein-Barr virus status on presenting features and outcome in age-defined subgroups of patients with classic Hodgkin lymphoma: a population-based study
Ruth F. Jarrett,
Gail L. Stark,
Jo White,
Brian Angus,
Freda E. Alexander,
Andrew S. Krajewski,
June Freeland,
G. Malcolm Taylor,
Penelope R. A. Taylor, for the Scotland and Newcastle Epidemiology of Hodgkin Disease Study Group
From the Leukaemia Research Fund (LRF) Virus Centre, Institute of Comparative Medicine, University of Glasgow, Glasgow, United Kingdom; the Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom; the University of Edinburgh, Edinburgh, United Kingdom; the Northampton General National Health Service (NHS) Trust, Northampton, United Kingdom; and St Mary's Hospital, Manchester, United Kingdom.
The association between tumor Epstein-Barr virus (EBV) status and clinical outcome in Hodgkin lymphoma (HL) is controversial. This population-based study assessed the impact of EBV status on survival in age-stratified cohorts of adults with classic HL (cHL). Data from 437 cases were analyzed with a median follow-up of 93 months. Overall survival (OS) was significantly better for EBV-negative compared with EBV-positive patients (P < .001), with 5-year survival rates of 81% and 66%, respectively; disease-specific survival (DSS) was also greater for EBV-negative patients (P = .03). The impact of EBV status varied with age at diagnosis. In patients aged 16 to 34 years, EBV-associated cases had a survival advantage compared with EBV-negative cases, but differences were not statistically significant (P = .21). Among patients 50 years or older, EBV positivity was associated with a significantly poorer outcome (P = .003). Excess deaths occurred in EBV-positive patients with both early- and advanced-stage disease. In multivariate analysis of OS in the older patients, EBV status retained statistical significance after adjusting for the effects of sex, stage, and B symptoms (P = .01). Impaired immune status may contribute to the development of EBV-positive cHL in older patients, and strategies aimed at boosting the immune response should be investigated in the treatment of these patients. (Blood. 2005;106:2444-2451)
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Related Letter in Blood Online:
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Impact of LMP-1 expression on clinical outcome in age-defined subgroups of patients with classical Hodgkin lymphoma
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Blood 2006 107: 1240-1241.
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