Whole blood EBV-DNA predicts outcome in diffuse large B-cell lymphoma

Abstract

An association between Epstein–Barr Virus (EBV) infection and lymphoproliferative diseases has been reported with EBV + diffuse large B cell-lymphoma (DLBCL) of the elderly described as a distinct entity. In a cohort of 218 human immunodeficiency virus (HIV)-negative patients with diffuse large B-cell lymphomas, we detected EBV-DNA in 25% of whole blood (WB) samples at diagnosis. Presence and viral load in WB, mononuclear cells or plasma did not predict the presence of EBV in the tumor biopsy. Positive Hepatitis C virus (HCV) serology was associated with a higher frequency of EBV in WB. Patients with EBV-DNA in WB had a significantly shorter progression-free (p = 0.02) and overall survival (p = 0.05) after immunochemotherapy with R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisolone). We conclude that detection of EBV in WB is not a surrogate marker for EBV-association in diffuse large B-cell lymphoma, however it associates with worse outcome.

Keywords:

• Diffuse large B-cell lymphoma
• EBV
• prognosis

Potential conflict of interest:

A disclosure form provided by the author is available with the full text of this article at www.informahealthcare.com/lal.

This work was supported by grants from AIRC (Associazione Italiana per la Ricerca sul Cancro), the Nadia Salcini Foundation and Fondi d’Ateneo, Linea D1, Università Cattolica del Sacro Cuore. M.G. was supported by Fondazione Roma - Progetto Cellule Staminali.

The authors thank Ilaria Pignatelli for helpful comments on the manuscript.

Supplementary materials are available online