Prognostic significance of Epstein-Barr virus (EBV) infection inHodgkin lymphoma patients.

Abstract

The prognostic significance of Epstein-Barr virus (EBV) infection in Hodgkin lymphoma (HL) is still controversial. In this work we sought to examine the prognostic differences between EBV-positive and -negative HL through a series of 131 cases from Tunisia. The status of EBV was assessed by EBV-encoded RNA (EBER) in situ hybridization. Results were correlated to patients' characteristics and outcome. EBV was detected in the malignant cells in 62 of 131 HL cases (47.3%). EBV-positive HL was associated with extreme age classes (≤15 and>45 years; p=0.0001), male gender (p=0.008), mixed cellularity histologic subtype (p=0.03), and inversely with leukocytosis (white blood cells ≥15000/mm3) (p=0.004) and bulky mediastinum (mediastinal-thoracic ratio≥ 0.35) (p=0.0001). On analysis of all patients, no significant difference between survival rates was found between EBV-positive and EBV-negative HL. In contrast, subgroups analysis revealed a negative effect of EBV infection in terms of overall survival in patients with Ann Arbor stages I/II (p=0.03) and nodular sclerosis HL subgroup (p=0.01), and in terms of event free survival in patients with mediastinal-thoracic ratio less than 0.35 (p=0.03). These results suggest that EBV infection affects the survival of particular subgroups of HL, especially those with early-stage of the disease.