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Leukemia & Lymphoma Volume 64, 2023 - Issue 5
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Original Articles

EBV-positive PCNSL in older patients: incidence, characteristics, tumor pathology, and outcomes across a large multicenter cohort

Prashasti Agrawala Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
,
Kevin A. Davidb Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
,
Zhengming Chena Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USAORCID Iconhttps://orcid.org/0000-0001-9437-6452
ORCID Icon,
Suchitra Sundaramc Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
,
Seo-Hyun Kimd Department of Internal Medicine, Division of Hematology, Oncology and Cell Therapy, Rush University Medical Center, Chicago, IL, USA
,
Ryan Vacae Department of Medicine, Penn State University College of Medicine, Hershey, PA, USA
,
Yong Linb Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
,
Samuel Singerf John Theurer Cancer Center, Hackensack, NJ, USA
,
Mary-Kate Malecekg Department of Medicine, Division of Hematology & Oncology, Washington University School of Medicine, University City, MO, USA
,
Jordan Carterb Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
,
Adam Zayach Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USAORCID Iconhttps://orcid.org/0000-0002-7591-2069
ORCID Icon,
Myung Sun Kimi Department of Internal Medicine, Oregon Health and Science University, Portland, OR, USA
,
Nishitha Reddyj Department of Medicine, Division of Hematology & Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
,
Douglas Neyk Department of Neurology, University of Colorado, Aurora, CO, USA
,
Alma Habibl Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota School of Medicine, Minneapolis, MN, USA
,
Christopher Strousem Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
,
Jerome Grabern Department of Neurology, University of Washington, Seattle, WA, USAORCID Iconhttps://orcid.org/0000-0001-5357-2932
ORCID Icon,
Veronika Bachanoval Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota School of Medicine, Minneapolis, MN, USA
,
Sidra Salmano Department of Medicine and Cancer Biology, Loyola University, Chicago, IL, USA
,
Jean A. Vendiolao Department of Medicine and Cancer Biology, Loyola University, Chicago, IL, USA
,
Nasheed Hossaino Department of Medicine and Cancer Biology, Loyola University, Chicago, IL, USA
,
Mazie Tsangp Department of Hematology/Oncology, University of California San Francisco, San Francisco, CA, USA
,
Ajay Majorq Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL, USAORCID Iconhttps://orcid.org/0000-0001-7261-1335
ORCID Icon,
Maher K. Gandhir Princess Alexandria Hospital, Brisbane, Australia
,
Colm Keaner Princess Alexandria Hospital, Brisbane, Australia
,
David A. Bonds Department of Medicine, Division of Hematology, The Ohio State University, Columbus, OH, USAORCID Iconhttps://orcid.org/0000-0003-0773-1829
ORCID Icon,
Matthew Folstadt Department of Medicine, Division of Hematology, Oncology and Palliative Care, University of Wisconsin, Madison, WI, USA
,
Julie Changt Department of Medicine, Division of Hematology, Oncology and Palliative Care, University of Wisconsin, Madison, WI, USA
,
Angel Mier-Hicksc Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
,
Pallawi Torkac Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
,
Priya Rajakumard Department of Internal Medicine, Division of Hematology, Oncology and Cell Therapy, Rush University Medical Center, Chicago, IL, USA
,
Parameswaran Venugopald Department of Internal Medicine, Division of Hematology, Oncology and Cell Therapy, Rush University Medical Center, Chicago, IL, USA
,
Stephanie Bergo Department of Medicine and Cancer Biology, Loyola University, Chicago, IL, USA
,
Michael Glantze Department of Medicine, Penn State University College of Medicine, Hershey, PA, USA
,
Samuel A. Goldlustf John Theurer Cancer Center, Hackensack, NJ, USA
,
Rahul Matnaniu Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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Pallavi Kumaru Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
,
Thomas A. Ollilah Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USAORCID Iconhttps://orcid.org/0000-0003-0102-6491
ORCID Icon,
Johnny Caii Department of Internal Medicine, Oregon Health and Science University, Portland, OR, USA
,
Stephen E. Spurgeoni Department of Internal Medicine, Oregon Health and Science University, Portland, OR, USA
,
Alex G. Siegm Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
,
Joseph Clevelandp Department of Hematology/Oncology, University of California San Francisco, San Francisco, CA, USA
,
Narendranath Epperlas Department of Medicine, Division of Hematology, The Ohio State University, Columbus, OH, USA
,
Reem Karmaliv Division of Hematology Oncology, Northwestern University, Chicago, IL, USA
,
Seema Naike Department of Medicine, Penn State University College of Medicine, Hershey, PA, USA
,
Sonali M. Smithq Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA
,
James L. Rubensteinp Department of Hematology/Oncology, University of California San Francisco, San Francisco, CA, USA
,
Brad S. Kahlg Department of Medicine, Division of Hematology & Oncology, Washington University School of Medicine, University City, MO, USA
,
Amy Chadburna Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
,
Andrew M. Evensb Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
&
Peter Martina Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USACorrespondence[email protected]
 show all
Pages 1026-1034 | Received 05 Sep 2022, Accepted 06 Mar 2023, Published online: 24 Mar 2023
 
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Abstract

The objective of this multicenter retrospective study was to examine the incidence, patient characteristics, pathology, and outcomes associated with Epstein-Barr virus (EBV)-related CNS lymphoma (CNSL) in older patients. Among 309 CNSL patients aged ≥60, 11.7% had EBV + tumors of which 72.2% were solid organ transplant (SOT)-related post-transplant lymphoproliferative disorders (PTLD). Younger age, SOT or autoimmune disease, and immunosuppressive treatment correlated highly with EBV-positivity. EBV + tumors were associated with absent C-MYC and BCL6 expression. EBV + PTLD was more likely to be associated with the absence of CD5 expression. EBV + non-PTLD had better median OS (not reached) compared to EBV + PTLD (10.8 months) and EBV-negative patients (43 months). Multivariable Cox regression analysis showed that age, performance status, and PTLD were negative predictors of OS. EBV status and immunosuppressive treatment were not correlated with OS. Our findings merit further investigation of EBV + PCNSL tumors and EBV-directed therapies.

Acknowledgements

Peter Martin and Amy Chadburn were supported by the following grant: NIH R01 CA260691.

Authors contributions

All authors provided data and reviewed the manuscript. Andrew Evens, Kevin David, Peter Martin, and Prashasti Agrawal developed the study concept. Peter Martin, Zhengming Chen, and Prashasti Agrawal performed data analysis.

Disclosure statement

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

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