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Epstein-Barr virus genome in non-Hodgkin's lymphomas occurring in immunocompetent patients: highest prevalence in nonlymphoblastic T-cell lymphoma and correlation with a poor prognosis. Danish Lymphoma Study Group, LYFO.
Blood. 1996 Feb 01; 87(3):1045-55.Blood

Abstract

A series of 520 cases of non-Hodgkin's lymphoma (NHL; 374 of B-cell, 130 of T-cell, 5 of non-B/non-T-cell, and 11 of undetermined phenotype) was analyzed for the presence of Epstein-Barr virus (EBV) using RNA in situ hybridization (RISH). The aims of the study were to assess the frequency of EBV-encoded small nuclear RNAs 1 and 2 (EBER), abundant immediate early RNAs (BHLF), and latent membrane protein-1 (LMP-1) in cases covering the entire histologic spectrum of NHL, and to analyze whether EBV status had prognostic relevance with regard to patient survival. EBER positivity was found in 25 of 374 (7%) B-NHL and 40 of 130 (31%) T-NHL (P < .00005) cases, but in only 1 of 16 cases with non-B/non-T-cell or undetermined phenotype. Among T-NHL cases, EBER positivity was confined to angioimmunoblastic, lymphadenopathy-like lymphoma (11 of 13 cases, 85%), Lennert's lymphoma (five of seven cases, 71%), and pleomorphic T-NHL (24 of 67 cases, 36%). Mycosis fungoides, lymphoblastic, and CD30-positive anaplastic large T-cell NHL cases were consistently EBV-negative. Double-labeling by RISH and immunophenotyping demonstrated the presence of EBV in neoplastic T cells, but no CD21 expression was found in the EBER-positive T-NHL cases. LMP-1 was expressed in 12 of 40 (30%) EBER-positive T-NHL and 5 of 25 (20%) EBER-positive B-NHL cases. For both T- and B-NHL, no correlation was found for EBER positivity and age, sex, clinical stage, or serum level of lactate dehydrogenase (LDH) at diagnosis. However, in T-NHL but not B-NHL, EBER positivity correlated with the presence of constitutional symptoms and a poor performance score (PS < 1; scale, 0 to 4). EBER status did not have any prognostic significance in B-NHL, but it had a negative prognostic impact in high-grade T-NHL (7-year survival of EBER-negative v EBER-positive cases: 33% v 14%; P = .01). A multivariate analysis including all B- and T-NHL of intermediate-/high-grade histology showed that EBER positivity in T-NHL was one of the three most significant factors recognized by the final prognostic model, only surpassed by PS greater than 1 and age greater than 67 years, and more powerful than B symptoms, an elevated LDH, or disseminated disease (clinical stage greater than II). We conclude that patients with EBV-positive T-NHL have a very poor clinical outcome, that EBV status should be considered as additional useful information in the classification of T-NHL, and that EBV-positive T-NHL should be treated as a separate entity in the future.

Authors+Show Affiliations

Department of Hematology, Odense University Hospital, Denmark.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8562929

Citation

d'Amore, F, et al. "Epstein-Barr Virus Genome in non-Hodgkin's Lymphomas Occurring in Immunocompetent Patients: Highest Prevalence in Nonlymphoblastic T-cell Lymphoma and Correlation With a Poor Prognosis. Danish Lymphoma Study Group, LYFO." Blood, vol. 87, no. 3, 1996, pp. 1045-55.
d'Amore F, Johansen P, Houmand A, et al. Epstein-Barr virus genome in non-Hodgkin's lymphomas occurring in immunocompetent patients: highest prevalence in nonlymphoblastic T-cell lymphoma and correlation with a poor prognosis. Danish Lymphoma Study Group, LYFO. Blood. 1996;87(3):1045-55.
d'Amore, F., Johansen, P., Houmand, A., Weisenburger, D. D., & Mortensen, L. S. (1996). Epstein-Barr virus genome in non-Hodgkin's lymphomas occurring in immunocompetent patients: highest prevalence in nonlymphoblastic T-cell lymphoma and correlation with a poor prognosis. Danish Lymphoma Study Group, LYFO. Blood, 87(3), 1045-55.
d'Amore F, et al. Epstein-Barr Virus Genome in non-Hodgkin's Lymphomas Occurring in Immunocompetent Patients: Highest Prevalence in Nonlymphoblastic T-cell Lymphoma and Correlation With a Poor Prognosis. Danish Lymphoma Study Group, LYFO. Blood. 1996 Feb 1;87(3):1045-55. PubMed PMID: 8562929.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epstein-Barr virus genome in non-Hodgkin's lymphomas occurring in immunocompetent patients: highest prevalence in nonlymphoblastic T-cell lymphoma and correlation with a poor prognosis. Danish Lymphoma Study Group, LYFO. AU - d'Amore,F, AU - Johansen,P, AU - Houmand,A, AU - Weisenburger,D D, AU - Mortensen,L S, PY - 1996/2/1/pubmed PY - 1996/2/1/medline PY - 1996/2/1/entrez SP - 1045 EP - 55 JF - Blood JO - Blood VL - 87 IS - 3 N2 - A series of 520 cases of non-Hodgkin's lymphoma (NHL; 374 of B-cell, 130 of T-cell, 5 of non-B/non-T-cell, and 11 of undetermined phenotype) was analyzed for the presence of Epstein-Barr virus (EBV) using RNA in situ hybridization (RISH). The aims of the study were to assess the frequency of EBV-encoded small nuclear RNAs 1 and 2 (EBER), abundant immediate early RNAs (BHLF), and latent membrane protein-1 (LMP-1) in cases covering the entire histologic spectrum of NHL, and to analyze whether EBV status had prognostic relevance with regard to patient survival. EBER positivity was found in 25 of 374 (7%) B-NHL and 40 of 130 (31%) T-NHL (P < .00005) cases, but in only 1 of 16 cases with non-B/non-T-cell or undetermined phenotype. Among T-NHL cases, EBER positivity was confined to angioimmunoblastic, lymphadenopathy-like lymphoma (11 of 13 cases, 85%), Lennert's lymphoma (five of seven cases, 71%), and pleomorphic T-NHL (24 of 67 cases, 36%). Mycosis fungoides, lymphoblastic, and CD30-positive anaplastic large T-cell NHL cases were consistently EBV-negative. Double-labeling by RISH and immunophenotyping demonstrated the presence of EBV in neoplastic T cells, but no CD21 expression was found in the EBER-positive T-NHL cases. LMP-1 was expressed in 12 of 40 (30%) EBER-positive T-NHL and 5 of 25 (20%) EBER-positive B-NHL cases. For both T- and B-NHL, no correlation was found for EBER positivity and age, sex, clinical stage, or serum level of lactate dehydrogenase (LDH) at diagnosis. However, in T-NHL but not B-NHL, EBER positivity correlated with the presence of constitutional symptoms and a poor performance score (PS < 1; scale, 0 to 4). EBER status did not have any prognostic significance in B-NHL, but it had a negative prognostic impact in high-grade T-NHL (7-year survival of EBER-negative v EBER-positive cases: 33% v 14%; P = .01). A multivariate analysis including all B- and T-NHL of intermediate-/high-grade histology showed that EBER positivity in T-NHL was one of the three most significant factors recognized by the final prognostic model, only surpassed by PS greater than 1 and age greater than 67 years, and more powerful than B symptoms, an elevated LDH, or disseminated disease (clinical stage greater than II). We conclude that patients with EBV-positive T-NHL have a very poor clinical outcome, that EBV status should be considered as additional useful information in the classification of T-NHL, and that EBV-positive T-NHL should be treated as a separate entity in the future. SN - 0006-4971 UR - https://www.unboundmedicine.com/medline/citation/8562929/Epstein_Barr_virus_genome_in_non_Hodgkin's_lymphomas_occurring_in_immunocompetent_patients:_highest_prevalence_in_nonlymphoblastic_T_cell_lymphoma_and_correlation_with_a_poor_prognosis__Danish_Lymphoma_Study_Group_LYFO_ DB - PRIME DP - Unbound Medicine ER -