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Blood, 1 August 2007, Vol. 110, No. 3, pp. 972-978.
Prepublished online as a Blood First Edition Paper on March 30, 2007; DOI 10.1182/blood-2007-01-067769.
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Submitted January 17, 2007
Accepted March 22, 2007
The impact of the Epstein-Barr Virus status on clinical outcome in diffuse large B cell lymphoma
Sarah Park, Jeeyun Lee, Young Hyeh Ko, Arum Han, Hyun Jung Jun, Sang Chul Lee, In Gyu Hwang, Yeon Hee Park, Jin Seok Ahn, Chul Won Jung, Kihyun Kim, Yong Chan Ahn, Won Ki Kang, Keunchil Park, and Won Seog Kim*
Division of Hematology-Oncology, Dept of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
* Corresponding author; email: wskimsmc{at}smc.samsung.co.kr.
In order to define the prognostic impact of Epstein Barr Virus (EBV) infection in diffuse large B cell lymphoma (DLBCL), we investigated the EBV status in DLBCL patients. In all, 380 slides from paraffin-embedded tissue were available for EBV analysis by EBER ISH, and 34 (9.0%) cases were identified as EBER-positive. EBER positivity was significantly associated with age > 60 years (P=.005), more advanced stage (P=<.001), more than one extranodal involvement (P=.009), higher IPI risk group (P=.015), the presence of B symptom (P=.004), and poorer outcome to initial treatment (P=.006). The EBER (+) DLBCL patients demonstrated substantially poorer OS (EBER(+) vs EBER(-); 35.8 months (95% CI, 0-114.1 months) vs not reached, respectively, P=.026) and PFS (EBER(+) vs EBER(-); 12.8(95% CI, 0-31.8 months) vs 35.8 months (95% CI, 0-114.1 months), respectively, P=.018). In non-GCB subtype, EBER ISH positivity retained its statistical significance at multivariate level (P=.045). Non-GCB DLBCL patients with EBER positivity showed substantially poorer OS with 2.9-fold (95% CI, 1.1 ?8.1) risk for death. In contrast, the EBER status did not affect survival with statistical significance in GCB DLBCL (P=.091). Taken together, DLBCL patients with EBER ISH(+) pursued more rapidly deteriorating clinical course with poorer treatment response, survival and PFS.
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Effect of EBV in Diffuse Large B-Cell Lymphoma
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