Abstract
BACKGROUND: Epstein Barr Virus (EBV) positive status is associated with poor survival in Hodgkin lymphoma and T cell NHL.
AIM: In order to define the prognostic impact of Epstein Barr Virus (EBV) infection in newly diagnostic nodal diffuse large B cell lymphoma (DLBCL), we investigated the EBV status in Peruvian DLBCL patients.
PATIENTS AND METHODS: Between January 2002 and December 2004, seventy-four patients, diagnosed with nodal DLBCL, were included in the analysis. Tissues from patients were analyzed for the presence of EBV encoded RNA (EBER) using the in situ hybridization (ISH)
RESULTS: Of the 74 cases, 53 cases (71.6%) were of the non Germinal Center DLBCL type (non GC). This group had a higher IPI than the Germinal Center DLBCL type (GC). Also the non GC DLBCL type had an inferior overall survival compared with GC DLBCL type, but the difference was not significant (p=0.171). Eleven cases (14.9%) were identified as EBER-positive. EBER positive was associated with an advanced age (> 60 years), poorer performance status, more advanced stage, higher IPI and poorer outcome to initial treatment. The EBER+ DLBCL patients demonstrated substantially poorer overall survival (EBER+ vs. EBER−): 1.1 months (95% CI, 0.0–2.6 months) vs. 15.5 months (1.0–30.0 months) respectively, (p=0.001). Most of the cases EBER (+) were of the non GC group. At the multivariable level, EBER status is an independent variable compared with the International Prognostic Index (IPI) (p=0.001) with a 3.2-fold (95% CI, 1.5–7.2) risk for death for positive cases.
CONCLUSION: EBV positive status in de novo, nodal DLBCL was present in 11/74 cases and is a powerful prognostic factor in this Peruvian population. EBV positive status correlated with advanced age, poor performance status, more advanced stage, non-GC group and short survival. New therapeutic strategies should be investigated in this poor prognostic subgroup.
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