Chang-Hsien Lu1, Kam-Fai Lee2, Chih-Cheng Chen3, Yi-Yang Chen4, Cih-En Huang4, Pei-Shan Tsai4, Hsing-Yi Tsou4, Hui-Ju Chou4, Miao-Fen Chen5, Pin-Tsung Chen1, Kuan-Der Lee6, Jrhau Lung7. 1. Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan. 2. Department of Pathology, Chang Gung Memorial Hospital, Chiayi. 3. Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi College of Medicine, Chang Gung University, Tao-Yuan, Taiwan ccchen1968@gmail.com jrhaulung@gmail.com. 4. Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi. 5. Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi College of Medicine, Chang Gung University, Tao-Yuan, Taiwan. 6. Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan College of Medicine, Chang Gung University, Tao-Yuan, Taiwan. 7. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chang Gung Memorial Hospital, Chiayi ccchen1968@gmail.com jrhaulung@gmail.com.
Abstract
OBJECTIVE: Epstein-Barr virus-positive diffuse large B-cell lymphoma is a provisional entity in the 2008 World Health Organization classification of tumors of hematopoietic and lymphoid tissues. Reports on the characteristics and clinical outcome of this disease in different geographic regions showed great disparities. METHODS: To define the clinical characteristics as well as the prognostic impact of Epstein-Barr virus infection on diffuse large B-cell lymphoma in Taiwan, we retrospectively investigated the Epstein-Barr virus status of 89 patients with newly diagnosed diffuse large B-cell lymphoma in our institute. RESULTS: Using a cutoff point of positive nuclear staining of Epstein-Barr virus-encoded RNA-1-in situ hybridization in ≥20% of the examined cells, we identified 15 cases (16.9%) of the entire study cohort as Epstein-Barr virus-positive diffuse large B-cell lymphoma. The clinical and laboratory features were not different between Epstein-Barr virus-positive and -negative diffuse large B-cell lymphoma patients. Univariate analysis showed patients with diffuse large B-cell lymphoma that were either Epstein-Barr virus-positive or had activated B-cell-like features had an inferior overall survival. Older age, advanced stage and lymphoma with activated B-cell-like features or Epstein-Barr virus-encoded RNA positivity were independent prognostic factors affecting overall survival on multivariate analysis. Patients with two or three of these adverse-risk factors were considered high risk and fared far worse than patients with no or only one adverse factor. CONCLUSIONS: Taken together, we demonstrated that a higher frequency of Epstein-Barr virus association was detected in a Taiwanese cohort of diffuse large B-cell lymphoma patients, and Epstein-Barr virus-encoded RNA positivity was shown to add important prognostic value in these patients.
OBJECTIVE:Epstein-Barr virus-positive diffuse large B-cell lymphoma is a provisional entity in the 2008 World Health Organization classification of tumors of hematopoietic and lymphoid tissues. Reports on the characteristics and clinical outcome of this disease in different geographic regions showed great disparities. METHODS: To define the clinical characteristics as well as the prognostic impact of Epstein-Barr virus infection on diffuse large B-cell lymphoma in Taiwan, we retrospectively investigated the Epstein-Barr virus status of 89 patients with newly diagnosed diffuse large B-cell lymphoma in our institute. RESULTS: Using a cutoff point of positive nuclear staining of Epstein-Barr virus-encoded RNA-1-in situ hybridization in ≥20% of the examined cells, we identified 15 cases (16.9%) of the entire study cohort as Epstein-Barr virus-positive diffuse large B-cell lymphoma. The clinical and laboratory features were not different between Epstein-Barr virus-positive and -negative diffuse large B-cell lymphomapatients. Univariate analysis showed patients with diffuse large B-cell lymphoma that were either Epstein-Barr virus-positive or had activated B-cell-like features had an inferior overall survival. Older age, advanced stage and lymphoma with activated B-cell-like features or Epstein-Barr virus-encoded RNA positivity were independent prognostic factors affecting overall survival on multivariate analysis. Patients with two or three of these adverse-risk factors were considered high risk and fared far worse than patients with no or only one adverse factor. CONCLUSIONS: Taken together, we demonstrated that a higher frequency of Epstein-Barr virus association was detected in a Taiwanese cohort of diffuse large B-cell lymphomapatients, and Epstein-Barr virus-encoded RNA positivity was shown to add important prognostic value in these patients.