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Prevalence and clinical implications of epstein-barr virus infection in de novo diffuse large B-cell lymphoma in Western countries.

Publication ,  Journal Article
Ok, CY; Li, L; Xu-Monette, ZY; Visco, C; Tzankov, A; Manyam, GC; Montes-Moreno, S; Dybkaer, K; Chiu, A; Orazi, A; Zu, Y; Bhagat, G; Chen, J ...
Published in: Clin Cancer Res
May 1, 2014

PURPOSE: Epstein-Barr virus-positive (EBV(+)) diffuse large B-cell lymphoma (DLBCL) of the elderly is a variant of DLBCL with worse outcome that occurs most often in East-Asian countries and is uncommon in the Western hemisphere. We studied the largest cohort of EBV(+) DLBCL, independent of age, treated with rituximab combined with CHOP (R-CHOP) in developed Western countries. EXPERIMENTAL DESIGN: A large cohort (n = 732) of patients with DLBCL treated with R-CHOP chemotherapy is included from the multicenter consortium. This study group has been studied for expression of different biomarkers by immunohistochemistry, genetic abnormalities by FISH and mutation analysis, genomic information by gene expression profiling (GEP), and gene set enrichment analysis (GSEA). RESULTS: Twenty-eight patients (4.0%) were positive for EBV with a median age of 60.5 years. No clinical characteristics distinguished patients with EBV(+) DLBCL from patients with EBV-negative (EBV(-)) DLBCL. Genetic aberrations were rarely seen. NF-κB p50, phosphorylated STAT-3, and CD30 were more commonly expressed in EBV(+) DLBCLs (P < 0.05). Significant differences in survival were not observed in patients with EBV(+) DLBCL versus EBV(-) DLBCL. However, CD30 expression combined with EBV conferred an inferior outcome. GEP showed a unique expression signature in EBV(+) DLBCL. GSEA revealed enhanced activity of the NF-κB and JAK/STAT pathways independent of molecular subtype. CONCLUSIONS: The clinical characteristics of patients with EBV(+) versus EBV(-) DLBCL are similar and EBV infection does not predict a worse outcome. EBV(+) DLBCL, however, has a unique genetic signature. CD30 expression is more common in EBV(+) DLBCL and, consistent CD30 and EBV is associated with an adverse outcome. Clin Cancer Res; 20(9); 2338-49. ©2014 AACR.

Duke Scholars

Published In

Clin Cancer Res

DOI

EISSN

1557-3265

Publication Date

May 1, 2014

Volume

20

Issue

9

Start / End Page

2338 / 2349

Location

United States

Related Subject Headings

  • Vincristine
  • Tumor Burden
  • Treatment Outcome
  • Survival Analysis
  • Rituximab
  • Prevalence
  • Prednisone
  • Phosphorylation
  • Oncology & Carcinogenesis
  • Neoplasm Staging
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Ok, C. Y., Li, L., Xu-Monette, Z. Y., Visco, C., Tzankov, A., Manyam, G. C., … Young, K. H. (2014). Prevalence and clinical implications of epstein-barr virus infection in de novo diffuse large B-cell lymphoma in Western countries. Clin Cancer Res, 20(9), 2338–2349. https://doi.org/10.1158/1078-0432.CCR-13-3157

Published In

Clin Cancer Res

DOI

EISSN

1557-3265

Publication Date

May 1, 2014

Volume

20

Issue

9

Start / End Page

2338 / 2349

Location

United States

Related Subject Headings

  • Vincristine
  • Tumor Burden
  • Treatment Outcome
  • Survival Analysis
  • Rituximab
  • Prevalence
  • Prednisone
  • Phosphorylation
  • Oncology & Carcinogenesis
  • Neoplasm Staging