Abstract
The role of the Epstein-Barr virus (EBV) status in the blood for predicting survival in post-transplantation lymphoproliferative disorders–diffuse large B-cell lymphoma (PTLD–DLBCL) is unknown. We evaluated the prognostic values of pre-treatment EBV-encoded small RNA (EBER) detected with in situ hybridization in tissues and EBV DNA in the whole blood (WB) and plasma in 58 patients with monomorphic PTLD–DLBCL after solid organ transplantation. There were no significant differences in the rates of overall response, complete response, and survival according to EBER EBV and WB EBV status. In contrast, patients with positive plasma EBV DNA had significantly lower rates of overall response (60.0% vs. 94.4%, P = 0.043) and complete response (40.0% vs. 88.9%, P = 0.019) as well as worse progression-free survival (PFS) (P = 0.035) and overall survival (OS) (P = 0.039) compared with patients with negative plasma EBV DNA. In multivariate analysis, plasma EBV DNA positivity was a significantly unfavorable prognostic factor for PFS [hazard ratio (HR) 4.92, 95% confidence interval (CI) 1.22–19.86, P = 0.025] and OS (HR 4.48, 95% CI 1.14–17.63, P = 0.032). Despite small number of 6 patients with plasma EBV positivity, plasma EBV DNA positivity might be more prognostic for survival than EBER or WB EBV DNA positivity in patients with monomorphic PTLD–DLBCL.
Highlights
The role of the Epstein-Barr virus (EBV) status in the blood for predicting survival in posttransplantation lymphoproliferative disorders–diffuse large B-cell lymphoma (PTLD–DLBCL) is unknown
A total of 70 adult patients with new onset monomorphic Post-transplantation lymphoproliferative disorder (PTLD) after solid organ transplantation were diagnosed at Asan Medical Center (Seoul, South Korea) between December 2004 and June 2019 (Fig. 1); of them, 58 patients with monomorphic PTLD–DLBCL were included in the analysis
We investigated the prognostic value of pre-treatment EBV status in the tissue and blood (WB and plasma) in patients who developed monomorphic PTLD–DLBCL after solid organ transplantation
Summary
The role of the Epstein-Barr virus (EBV) status in the blood for predicting survival in posttransplantation lymphoproliferative disorders–diffuse large B-cell lymphoma (PTLD–DLBCL) is unknown. We evaluated the prognostic values of pre-treatment EBV-encoded small RNA (EBER) detected with in situ hybridization in tissues and EBV DNA in the whole blood (WB) and plasma in 58 patients with monomorphic PTLD–DLBCL after solid organ transplantation. Regarding the prognostic value of EBV status in PTLD, previous studies reported discordant results on the effect of EBV status on survival in PTLD patients based on EBER-ISH of the primary tumor[11,12,13,14,15,16]. We compared the prognostic values of EBER, WB EBV DNA, and plasma EBV DNA in a homogeneous group of patients with monomorphic PTLD–DLBCL after solid organ transplantation who were treated with chemotherapy
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