Latent Epstein–Barr virus infection status and prognosis in patients with newly diagnosed Hodgkin lymphoma in Southeast China: a single-center retrospective study

Figures & data

Figure A. Proportion of EBV positive patients in different age groups.

Figure B. Overall survival and failure-free survival among HL patients whose EBV infection status was classified 1. Overall survival and failure-free survival for the entire study population 2. Overall survival by EBV infection status in patients of all ages 3. Progression-free survival by EBV infection status in patients of all ages 4-6. Progression-free survival by EBV infection status in patients of different age subgroups.

Table A. General clinical characteristics of patients with Hodgkin lymphoma.

Factors	EBV(n=62)		EBV-(n=72)		P-value
	No.	%	No.	%
Sex
Male	44	71.0	39	54.2	0.046*
Female	18	29.0	33	45.8
Age
0 ∼14	6	9.7	2	2.8	0.004†
15∼34	22	35.5	47	65.3
35∼49	15	24.2	12	16.7
50∼74	19	30.6	11	15.3
Ann Arbor stage
I∼II	30	48.4	45	62.5	0.101*
III∼IV	32	51.6	27	37.5
B symptoms
Present	23	37.1	32	44.4	0.389*
Absent	39	62.9	40	55.6
Bulky disease
Present	9	14.5	15	20.8	0.428*
Absent	46	74.2	53	73.6
Unknown	7	11.3	4	5.6
Location
Nodal only	40	64.5	58	80.6	0.037*
Extranodal	22	35.5	14	19.4
Treatment
Chemotherapy only	45	72.6	45	62.5	0.215*
Chemotherapy and RT	17	27.4	27	37.5
Subtype
NLPHL	2	3.2	5	6.9	< .001†
NSHL	18	29.0	50	69.4
MCHL	35	56.5	13	18.1
LRCHL	5	8.1	2	2.8
LDHL	0	0	1	1.4
Unclassified cHL	2	3.2	1	1.4
Unfavorable risk factors (GHSG criteria‡, stage I∼II, n=75)
0	12	–	13	–	0.226*
≥ 1	18	–	32	–
IPS§ (stage III∼IV, n=59)
0 ∼ 2	18	–	15	–	0.583*
≥ 3	14	–	12	–

Abbreviations: NLPHL, lymphocyte predominant Hodgkin lymphoma; NSHL, nodular sclerosis Hodgkin lymphoma; MCHL, mixed cellularity Hodgkin lymphoma; LRCHL, lymphocyte-rich classical Hodgkin lymphoma; LDHL, lymphocyte depletion Hodgkin lymphoma; cHL, classical Hodgkin lymphoma.

*χ² test for independence in EBV⁺ compared with EBV^- HL patients.

†Fisher exact test for independence in EBV⁺ compared with EBV^- HL patients.

‡ GHSG criteria for ‘unfavorable’ included any EN (extranodal) disease, MMR (mediastinal mass ratio) >1/3, > 2 lymph node regions involved, ESR (erythrocyte sedimentation rate) >50 or >30 if B symptoms were present.

§IPS was defined as the number of adverse prognostic factors present at diagnosis. Seven factors had similar independent prognostic effects: a serum albumin level of less than 4 g per deciliter, a hemoglobin level of less than 10.5 g per deciliter, male sex, an age of 45 years or older, stage IV disease (Ann Arbor classification), leukocytosis (a white-cell count of at least 15,000 per cubic millimeter), and lymphocytopenia (a lymphocyte count of less than 600 per cubic millimeter, a count that was less than 8 percent of the white-cell count, or both).

Table B. Curative effect of treatment.

	EBV+		EBV-		P-value
	No.	%	No.	%
First-line treatment
CR/CRu	45	72.6	45	62.5	0.181*
PR	16	25.8	23	31.9
SD	1	1.6	3	4.2
PD	0	0	1	1.4
Salvage chemotherapy^†
CR achieved	3	27.3	8	57.1	0.227^‡
CR unachieved	8	72.7	6	42.9

*Compared by the Mann-Whitney test.

† 25 evaluable cases, 11 EBV⁺HL and 14 EBV^-HL.

‡ Compared by Fisher exact test.

Table C. Univariate Analysis of FFS.

Factors	No. of Patients	5-year FFS		P-value
		%	SD
Sex
Male	83	78.1	5.1	0.647
Female	51	74.8	6.7
Age
0 ∼14	8	100	–	0.025
15∼34	69	76.1	5.7
35∼49	27	91.2	6.0
50∼74	30	59.5	10.4
Ann Arbor stage
I∼II	75	86.8	4.4	0.003
III∼IV	59	65.1	7.0
B symptoms
Present	55	69.2	6.5	0.080
Absent	79	83.7	4.9
Bulky disease
Present	24	52.1	10.5	0.001
Absent	99	85.1	4.0
Unknown	11	–	–
Location
Nodal only	98	80.5	4.4	0.100
Extranodal	36	67.0	8.7
Treatment
Chemotherapy only	90	77.2	5.0	0.948
Chemotherapy and RT	44	76.0	7.0
Subtype
NSHL	68	74.2	5.8	0.417
MCHL	48	83.7	5.7
Other	18	65.9	14.5
EBV, all ages
Negative	72	83.3	4.6	0.123
Positive	62	68.9	6.9
EBV, 15–34 years
Negative	47	79.3	6.2	0.631
Positive	22	67.3	12.3
EBV, 50–74 years
Negative	11	90.9	8.7	0.012
Positive	19	38.5	13.5

Table D. Multivariate Analysis of FFS using a Cox Regression Model.

Factors	HR	95% CI		P-value
		Lower	Upper
All ages
Ann Arbor stage	3.438	1.411	8.377	0.007
Bulky disease	3.548	1.559	8.076	0.003
Age 50∼74
Ann Arbor stage	4.899	1.002	23.938	0.050
EBV	10.095	1.257	81.080	0.030