Epstein-Barr Virus-Latent Membrane Protein 1 Expression Has a Favorable Influence in the Outcome of Patients with Hodgkin's Disease Treated with Chemotherapy

Abstract

The effect of molecular factors in the outcome of Hodgkin's Disease (HD) is being currently studied. In a previous series of HD. including patients treated only with radiotherapy and patients treated with chemotherapy (with or without radiotherapy). we found that a high proliferation index had an adverse influence in overall survival (OS) and in the achievement of a complete remission (CR). Loss of Rb expression also had an adverse prognostie influence in achievement of CR. On the other hand LMPI-EBV expression had a favorable influence for OS. The expression of other molecular factors. P53, be12 and CD15 did not show prognostic influcnce. In the present paper we have studied the effect of the e molecular variables in 110 patients, of the previous series who had been treated with chemotherapy. A retrospective study was performed in these 110 patients with HD treated with chemotherapy (ABVD or variants, 62%. or regimes not containing adriamycin, 38%) with or without adjutant radiotherapy, collected at the 11 centers belonging to the Spanish Collaborative Group for the Study of Hodgkin's Disease. The prognostie value of clinical variables and the expression of p53. be12. CD15. Rb, LMP I-EBV and proliferative fraction demonstrated with sensitive immunohistochemical methods were studied. Cox's multivariate analysis was performed to assess their influence in failure-free survival (FFS) and OS. A multivariate logistic regression analysis was perfomied for studying the effect of the variables in the achievement of a CR.

Of the clinical variables, only advanced stage (III/IV) had a significant independent adverse influence in FFS, in OS and in the achievement of CR and advanced age in OS. Of the molecular variables, LMPI-EBV had an independent and strong favorable influence in FFS, in OS and in the achievement of CR. Rb expression had a modest favorable influence in CR. The rest of the molecular variables had no independent influence on the outcome of the disease. In conclusion these results confirm the favorable prognostic value of LMPl -EBV expression in the subset of patients with HD treated with chemotherapy.

Key Words:

• Hodgkin's Disease
• LMPl-EBV
• Rb
• bcl-2
• p53
• CD 15
• proliferative index
• prognostic factors

Additional information

Notes on contributors

Carlos Montalban

Joyce Laing works in the Department of Child and Family Psychiatry, Playfield House, Cupar, Fife, and is a Consultant Art Therapist to Psychiatric Hospitals and Prisons and Chairwoman of the Scottish Society of Art and Psychology.