Epstein-Barr virus-based prognostic model in nodular sclerosis classic Hodgkin lymphoma

Abstract

The role of Epstein-Barr virus (EBV) in lymphoma cells of nodular sclerosis classic Hodgkin lymphoma (NScHL) is controversial. Our aim was to explore this and establish a clinically feasible model for risk stratification. We interrogated data from 542 consecutive subjects with NScHL receiving ABVD therapy and demonstrated EBV-infection in their lymphoma cells with EBV-encoded small RNAs (EBERs) in situ hybridization. Subjects were divided into training and validation datasets. As data from the training dataset suggested EBERs-positivity was the only independent prognostic factor for both progression-free survival (PFS) and overall survival (OS), we developed corresponding prognostic models based on it. Our models showed excellent performance in both training and validation cohort. These data indicate the close association of EBV infection and the outcomes of persons with NScHL receiving ABVD. Additionally, our newly developed models should help physicians estimate prognosis and select individualized therapy.

Keywords: Cancer; Immunology; Public health.

Graphical abstract

Figure 1

CONSORT flow diagram

Figure 2

EBV-based prognostic model (A) PFS and OS model; (B) K-M plot of PFS in the training cohort; (C) K-M plot of OS in the training cohort; (D) K-M plot of PFS in the validation cohort; (E) K-M plot of OS in the validation cohort. ∗ IPS was calculated for stage III/IV disease. Subjects with stage III/IV disease, IPS ≥4 were considered to have this risk factor and others not.