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Blood, Vol. 94 No. 2 (July 15), 1999:
pp. 442-447
Effect of Epstein-Barr Virus Infection on Response to Chemotherapy
and Survival in Hodgkin's Disease
Paul G. Murray,
Lucinda J. Billingham,
Hassan T. Hassan,
Joanne R. Flavell,
Paul N. Nelson,
Kenneth Scott,
Gary Reynolds,
Christothea M. Constandinou,
David J. Kerr,
Elaine C. Devey,
John Crocker, and
Lawrence S. Young
From the CRC Institute for Cancer Studies, University of Birmingham,
Birmingham, UK; the Division of Biomedical Sciences, School of Health
Sciences, University of Wolverhampton, Wolverhampton, UK; the
Department of Histopathology, New Cross Hospital, Wolverhampton, UK;
the Department of Histopathology, Russells Hall Hospital, Dudley, West
Midlands, UK; and the Department of Histopathology, Birmingham
Heartland's Hospital, Bordesley Green East, Birmingham, UK.
We have analyzed paraffin sections from 190 patients with
histologically confirmed Hodgkin's disease (HD) for the presence of
Epstein-Barr virus (EBV) using in situ hybridization to detect the
EBV-encoded Epstein-Barr virus early RNAs (EBERs) and
immunohistochemistry to identify latent membrane protein-1 (LMP1)
expression. EBV was present in the tumor cells in 51 HD cases (27%)
and was mainly confined to the mixed cellularity and nodular sclerosis
subtypes. There was no difference between EBV-positive and EBV-negative HD patients with regard to age, clinical stage, presentation, and the
number of alternating chemotherapy cycles of ChIVPP and PABIOE
received. The complete remission rate after study chemotherapy was 80%
in EBV-positive patients versus 69% in EBV-negative patients (P = .05). The 2-year failure-free survival rate was
significantly better for EBV-positive patients when compared with the
EBV-negative HD group (P = .02). Although 2-year and 5-year
overall survival rates were better for EBV-positive HD patients, the
differences were not statistically significant (P = .18 and
P = .40, respectively). In conclusion, the results confirm
the favorable prognostic value of EBV in the tumor cells of HD patients
and suggest important differences in response to chemotherapy between
EBV-positive and EBV-negative patients.
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