Assessment of tumor Epstein-Barr Virus status and its impact on outcomes in intermediate and high-risk childhood classic Hodgkin Lymphoma treated at a tertiary cancer center in India

Abstract

Indian studies on EBV in childhood classic Hodgkin Lymphoma (cHL) have mainly analyzed the epidemiology of EBV-positive [EBV(+)HL] or negative HL [EBV(–)HL], with limited data on outcomes. We studied a large cohort of children with intermediate and high-Risk cHL for tumor EBV status and its impact on outcomes retrospectively. Of evaluable 189 patients, 84.7% had EBV(+)HL. Positive status was significantly associated with age ≤ 10 years (p < .001), males (p = .015), non-Nodular Sclerosis (NS) histology (p = .004) and inversely with bulky-mediastinal disease (p < .001). At a median follow-up of 29-months (range1–75), 3-year Event-Free Survival (EFS) for EBV(+)HL and EBV(–)HL was 93.6%(95%CI:89.8%–97.5%), 81.1%(95%CI:67.2%–97.9%), (p = .048) and Overall Survival (OS) was 94.9%(95%CI:91.6%–98.4%), 84.6%(95%CI:71.5%–100%), (p = .075) respectively. Three-year EFS was better in males (HR-0.267,95%CI:0.078–0.916, p = .036) in EBV(+)HL and in patients with serum-albumin > 3g/dL (HR-0.117,95%CI:0.019–0.705, p = .019) in EBV(–)HL. EBV is associated with most of intermediate and high-risk childhood cHL, occurs in younger male patients with non-NS histology, with reduced incidence of bulky-mediastinal disease and favorable survival in childhood cHL.

Keywords:

• EBV
• Hodgkin Lymphoma
• outcome
• impact
• prognosis

Acknowledgements

The team would like to acknowledge Ms Smruti Mokal, statistician for the support provided in statistical analysis.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.