P17.85 * LOW LEVELS OF HUMAN CYTOMEGALOVIRUS INFECTION IN GLIOBLASTOMA MULTIFORME ASSOCIATES WITH PATIENT SURVIVAL; A PROSPECTIVE STUDY

Abstract

BACKGROUND: Over 90% of GBM tumors have been shown to be infected with human cytomegalovirus (HCMV). In this study, we evaluated whether there was an association between the grade of HCMV infection and long-term survival in GBM patients. MATERIAL AND METHODS: Brain tumor tissue sections from consecutive GBMs patients operated at the Karolinska University Hospital from 2003 were analysed (n= 250). HCMV infection grade was determined by the number of HCMV positive cells negative (or grade 1-4) by immunohistochemistry. Chi-Square test and logistic regression analysis were used to assess an association between long-term survival and HCMV low-grade infection or other clinical prognostic parameters; age under 50 years, radical surgery or low recursive partition analysis (RPA) and MGMT status. RESULTS: HCMV infection was detected in tumor samples from 249 of 250 patients (99%). Forty percent of GBM patients who lived > 18 months had low-grade HCMV infection while only 8% GBM patients who lived < 18 months did. In the first 75 cases, multiple logistic regression analyses yielded an odds ratio estimate of 6.61 with 95% confidence interval (1.36-32.1) (p .019) for low grade HCMV after adjustment for RPA class, radical surgery, and age. CONCLUSION: We previously reported that low-grade HCMV infection was strongly associated with long-term survival in GBM patients in a case-control study of 75 patients. This larger prospective study of patients treated at a single institution confirms the previous data. As a consequence, CMV analysis by immunohistochemistry could be use as a prognostic marker in glioblastoma.