Epstein-Barr Virus-Positive Diffuse Large B cell Lymphoma in the Experience of a Tertiary Medical Center in Poland.

Mateusz Ziarkiewicz,Dominika Wołosz,Tomasz Dzieciątkowski,Jadwiga Dwilewicz-Trojaczek,Wiesław Wiktor Jędrzejczak,Ewa Wilczek,Beata Gierej,Bogna Ziarkiewicz-Wróblewska

doi:10.1007/s00005-015-0341-2

Abstract

The role of Epstein–Barr virus (EBV) in the biology and clinical characteristics of diffuse large B cell lymphoma (DLBCL) is still poorly defined. A new provisional entity EBV-positive DLBCL of the elderly has been described in Asian population. Its incidence and prognosis remains unknown in middle European patients. Clinical data and tissue samples were collected from 74 Caucasian patients with DLBCL, aged between 23 and 86 years, treated at a single institution. Lymphoma morphology was reassessed, laboratory procedures included in situ hybridization specific for EBV-encoded small RNAs (EBER), immunohistochemical staining for latent membrane protein and serological testing for EBV-specific antibodies. EBER staining revealed 12.2 % of EBV-positive cases, whereas 9.5 % were diagnosed as EBV-positive DLBCL of the elderly. Serologic EBV markers did not correlate with the presence of EBV in tissue samples (P > 0.10). Elderly EBV-positive cases had lower BCL-6 (P = 0.038) and higher CD30 (P = 0.049) expression and were characterized by higher progression risk (median time-to-progression 12.5 months vs not reached; P = 0.029) and a trend towards worse overall survival (median overall survival 24.5 months vs not reached; P = 0.059). EBV-positive DLBCL of the elderly occurs relatively frequently in Polish population and may be associated with inferior prognosis in comparison with DLBCL, not otherwise specified.

Highlights

Epstein–Barr virus (EBV) is a member of c-herpesvirinae subfamily, one of the most important groups of oncogenic viruses (Cohen et al 2008; Rezk and Weiss 2007; Schuster and Muschen 2003)
The aim of the present study was to examine the incidence of EBV infection in a historical cohort of consecutive diffuse large B cell lymphoma (DLBCL) cases treated at a single center (Medical University of Warsaw, Warsaw, Poland), with special emphasis on EBV-positive DLBCL of the elderly subtype, and to test the prognostic impact of EBV-related parameters
In the present study we described EBV infection and its prognostic impact in a sample of Polish DLBCL patients with special emphasis on the clinicopathologic characteristics of EBV-positive DLBCL of the elderly

Summary

Introduction

Epstein–Barr virus (EBV) is a member of c-herpesvirinae subfamily, one of the most important groups of oncogenic viruses (Cohen et al 2008; Rezk and Weiss 2007; Schuster and Muschen 2003) It has been isolated for the first time by Michael Epstein and Yvonne Barr in 1964 from the Burkitt lymphoma cell line (Epstein et al 1965). EBV causes both acute and chronic infections, with seropositivity in IgG class reaching 90 % of the adult population. It infects both epithelial cells and lymphocytes, with special inclination to CD21high B memory cells, which constitute the viral reservoir in latent infections. All EBV-infected cells contain large amounts of small noncoding fragments of viral RNA (EBV-encoded small RNAs: EBER) that are useful for clinical diagnosis (Rezk and Weiss 2007)

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