Abstract
Recent studies show that Epstein-Barr virus (EBV) positivity might be related to adverse prognosis in patients with diffuse large B-cell lymphoma (DLBCL), but the results are still inconclusive. We conducted this meta-analysis to define the clinical value of EBV infection in DLBCL. All potential articles in PubMed, Web of Science, Medline, and Embase were retrieved. Using the random-effects or fixed-effect model, pooled hazard ratios (HRs) or relative risk (RR) with 95% confidence intervals (CIs) were used to calculate the correlation between EBER and prognosis and clinical features in DLBCL. A total of 13 qualified studies with 4111 patients were identified in our meta-analysis based on the inclusion and exclusion criteria. The overall estimates revealed that EBV-encoded small RNAs (EBER) positivity was significantly correlated with worse overall survival (HR = 2.43, 95% CI: 1.73–3.36) and progression-free survival (HR = 3.60, 95% CI: 2.07–6.26). In addition, EBER positivity was associated with age older than 60 years (RR = 1.51, 95% CI: 1.02–2.24), male sex (RR = 1.34, 95% CI: 1.05–1.71), more advanced stage (RR = 2.25, 95% CI: 1.72–2.96), high international prognostic index (RR = 2.20, 95% CI: 1.71–2.82), more than one extranodal involvement (RR = 1.69, 95% CI: 1.27–2.26), presence of B symptom (RR = 1.75, 95% CI: 1.30–2.35), non-germinal center B-cell subtype (RR = 1.35, 95% CI: 1.03–1.78), and elevated lactate dehydrogenase levels (RR = 1.30, 95% CI: 0.98–1.72). EBER positivity was correlated with worse outcomes, worse clinical course, and adverse clinicopathologic features among patients with DLBCL.
Highlights
Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma, accounting for 30%–40% of all initially diagnosed cases [1]
Many studies demonstrated that EBV-encoded small RNAs (EBER) positivity indicated worse clinical features and poor prognosis in DLBCL patients, there is still no unified conclusion
Consistent with other findings, our results revealed that patients with EBER-positive DLBCL tended to be men, aged >60 years, who had higher International Prognostic Index (IPI) scores, a non-germinal center B-cell (GCB) immunophenotype, more than one extranodal site, an advanced disease stage, B symptom, and elevated lactate dehydrogenase (LDH) levels
Summary
Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma, accounting for 30%–40% of all initially diagnosed cases [1]. It is an invasive lymphoma with heterogeneous histology, clinical features, surface marker expression, and clinical outcomes [2]. The IPI score does not reflect the biological changes of tumor patients with DLBCL. The development of rituximab has transformed the chemotherapy regimen for aggressive lymphoma and led to remarkable progress in the outcome of DLBCL regardless of its IPI risk category [4]. Identifying other valuable prognostic factors that can be used for the stratified treatment of DLBCL is crucial
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
