Prognostic impact of circulating Epstein-Barr virus (EBV) DNA concentration and EBV serology in T-cell non-Hodgkin’s lymphoma (T-NHL)

Abstract

8556 Background: The level of circulating EBV DNA concentration is a prognostic marker in patients with some EBV-associated malignant diseases. To evaluate the prognostic impact of serum EBV DNA and serum anti-EBV antibodies in T-NHL, this prospective study was conducted by our cancer center. Methods: From Jan 2002 to Dec 2006, paired plasma and serum samples from 125 previously untreated T-NHL patients were collected and subjected to a real-time quantitative polymerase chain reaction (PCR) assay for EBV DNA measurement and an immunoenzyme assay for anti-EBV antibodies(VCA-IgA, EA-IgA). The patients were including 49 extranodal NK/T cell lymphoma, nasal type (ENKL), 34 peripheral T-cell lymphoma unspecified, 21 anaplalstic large cell lymphoma, 15 lymphoblastic T-cell lymphoma, 5 angioimmunoblastic T-cell lymphoma, 1 subcutaneous panniculitis-like T-cell lymphoma. The effects of both assays on the prognosis of patient were thoroughly investigated. Results: The positive rate of circulating EBV DNA is 39.2%, with a median concentration of 13400 copies/ml. The EBV DNA positive rate of ENKL is 69.4%, higher than other subtypes (P<0.001).The positive circulating EBV DNA group has a lower complete remission (CR) rate(38.8%vs57.9%, P=0.037), higher relapse rate(42.1%vs18.2%, P=0.045)than negative one. A significant correlation is also found between the EBV DNA level and CR rate in ENKL subtype. The 5-year DFS and 5-year OS decreased with the dose of circulating EBV DNA group (DFS: negative group74.4% VS ≤13400 copies/ml group62.9% VS >13400 copies/ml group25.7%,P=0.015; OS: negative group 60.2% VS ≤13400copies/ml group 52.6% VS >13400copies/ml group 42.9%,P=0.03). The positive rates of VCA-IgA and EA-IgA are 30.6% and 1.6% respectively, and both of the titers could not predict the efficacy and survivals. Conclusions: The positive rate of circulating EBV DNA is much higher in ENKL than other subtypes of T- NHL. Circulating EBV DNA concentration, as measured by real-time PCR, is superior to serum anti-EBV antibodies in prognostic predictions for T-NHL, and patients with higher EBV DNA load may undergo more aggressive biological behavior. No significant financial relationships to disclose.