Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Sep;105(9):1170-5.
doi: 10.1111/cas.12467. Epub 2014 Sep 8.

Clinical outcome of Epstein-Barr virus-positive diffuse large B-cell lymphoma of the elderly in the rituximab era

Ai Sato  1 , Naoya Nakamura, Minoru Kojima, Ken Ohmachi, Joaquim Carreras, Yara Yukie Kikuti, Hiroki Numata, Daisuke Ohgiya, Kei Tazume, Jun Amaki, Makiko Moriuchi, Mitsuki Miyamoto, Yasuyuki Aoyama, Hidetsugu Kawai, Akifumi Ichiki, Ryujiro Hara, Hiroshi Kawada, Yoshiaki Ogawa, Kiyoshi Ando
Affiliations

Clinical outcome of Epstein-Barr virus-positive diffuse large B-cell lymphoma of the elderly in the rituximab era

Ai Sato et al. Cancer Sci. 2014 Sep.

Abstract

Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of malignant lymphoma. The incidence of Epstein-Barr virus (EBV)-positive DLBCL in Asian and Latin American countries ranges from 8 to 10%. The prognosis of patients with EBV-positive DLBCL is controversial. To compare the clinical outcome of EBV-positive and EBV-negative patients with DLBCL in the rituximab era, we analyzed 239 patients with de novo DLBCL diagnosed between January 2007 and December 2011. The presence of EBV in lymphoma cells was detected using EBV-encoded RNA in situ hybridization, and it was found that 18 (6.9%) of 260 patients with diagnosed DLBCL tested positive. Among the 260 cases, 216 cases were treated with rituximab plus chemotherapy, as were 8 EBV-positive DLBCL patients. The median overall survival and progression-free survival times in patients with EBV-positive DLBCL were 8.7 months and 6.8 months, respectively. The median overall survival and progression-free survival could not be determined in EBV-negative DLBCL patients (P = 0.0002, P < 0.0001, respectively). The outcome of patients with EBV-positive DLBCL remains poor, even in the rituximab era.

Keywords: Diffuse large B-cell lymphoma; Epstein-Barr virus (EBV); prognosis.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Overall survival (OS) in immunocompetent Epstein–Barr virus (EBV)-positive versus EBV-negative patients with diffuse large B-cell lymphoma. The median OS in EBV-positive patients was 8.7 months; OS could not be determined in EBV-negative patients. Hazard ratio = 3.9; 95% confidence interval, 4.0–49.3; P < 0.0001.
Fig 2
Fig 2
Survival analysis in patients with diffuse large B-cell lymphoma (DLBCL) treated with chemotherapy regimens similar to rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone. (a) Overall survival (OS). The median OS in Epstein–Barr virus (EBV)-positive DLBCL patients was 8.7 months; OS could not be determined in EBV-negative patients. Hazard ratio = 4.3; 95% confidence interval, 3.6–121.6; P = 0.0002. (b) Progression-free survival (PFS). The median PFS in EBV-positive DLBCL patients was 6.8 months; median PFS could not be determined in EBV-negative patients. Hazard ratio = 5.6; 95% confidence interval, 13.0–384.6; P < 0.0001.
See this image and copyright information in PMC

References

    1. Lymphoma Study Group of Japanese Pathologists. The World Health Organization classification of malignant lymphomas in Japan: incidence of recently recognized entities. Pathol Int. 2000;50:696–702. - PubMed
    1. Jaffe ES, Pittaluga S. Aggressive B-cell lymphomas: a review of new and old entities in the WHO classification. Hematology Am Soc Hematol Educ Program. 2011;2011:506–14. - PMC - PubMed
    1. Campo E, Swerdlow SH, Harris NL, Pileri S, Stein H, Jaffe ES. The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood. 2011;117:5019–32. - PMC - PubMed
    1. Swerdlow SH, Campo E, Harris NL, et al. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th edn. Lyon, France: IARC Press; 2008.
    1. Gibson SE, Hsi ED. Epstein-Barr virus-positive B-cell lymphoma of the elderly at a United States tertiary medical center: an uncommon aggressive lymphoma with a nongerminal center B-cell phenotype. Hum Pathol. 2009;40:653–61. - PubMed

MeSH terms