The impact of Epstein-Barr virus
status on clinical outcome in diffuse large
B-cell lymphoma.
Park S, Lee J, Ko YH, Han
A, Jun HJ, Lee SC, Hwang IG, Park YH, Ahn
JS, Jung CW, Kim K, Ahn YC, Kang WK, Park K,
Kim WS.
Division of
Hematology-Oncology, Department of Medicine,
Samsung Medical Center, Sungkyunkwan University
School of Medicine, 50 Ilwon-dong Kangnam-ku,
Seoul 135-710, Korea.
To define prognostic impact
of Epstein-Barr virus (EBV) infection in diffuse
large B-cell lymphoma (DLBCL), we investigated
EBV status in patients with DLBCL. In all, 380
slides from paraffin-embedded tissue were
available for analysis by EBV-encoded RNA-1 (EBER)
in situ hybridization, and 34 cases (9.0%) were
identified as EBER-positive. EBER positivity was
significantly associated with age greater than
60 years (P = .005), more advanced stage (P <
.001), more than one extranodal involvement (P =
.009), higher International Prognostic Index (IPI)
risk group (P = .015), presence of B symptom (P
= .004), and poorer outcome to initial treatment
(P = .006). The EBER(+) patients with DLBCL
demonstrated substantially poorer overall
survival (EBER(+) vs EBER(-) 35.8 months [95%
confidence interval (CI), 0-114.1 months] vs not
reached, P = .026) and progression-free survival
(EBER(+) vs EBER(-) 12.8 months [95% CI, 0-31.8
months] vs 35.8 months [95% CI, 0-114.1 months],
respectively (P = .018). In nongerminal center
B-cell-like subtype, EBER in situ hybridization
positivity retained its statistical significance
at the multivariate level (P = .045).
Nongerminal center B-cell-like patients with
DLBCL with EBER positivity showed substantially
poorer overall survival with 2.9-fold (95% CI,
1.1-8.1) risk for death. Taken together, DLBCL
patients with EBER in situ hybridization+
pursued more rapidly deteriorating clinical
course with poorer treatment response, survival,
and progression-free survival.
PMID: 17400912 [PubMed - indexed
for MEDLINE]