Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma in the Elderly: A Matched Case-Control Analysis
Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) in the elderly has rarely been reported. This study aimed to explore the clinical characteristics and prognosis of this entity. In situ hybridization (ISH) analysis of Epstein-Barr virus (EBV) and immunohistochemistry was perfor...
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| Veröffentlicht in: | PloS one 2015-07, Vol.10 (7), p.e0133973-e0133973 |
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| description | Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) in the elderly has rarely been reported. This study aimed to explore the clinical characteristics and prognosis of this entity.
In situ hybridization (ISH) analysis of Epstein-Barr virus (EBV) and immunohistochemistry was performed in 230 tumor specimens from consecutive de novo DLBCL patients over 50 years old. A matched-case control analysis (1:3) was utilized to compare EBV-positive and EBV-negative DLBCL in the elderly.
A total of 16 patients (7.0%) were diagnosed with EBV-positive DLBCL. Of these 16 cases, the median age was 62 years, with a male to female ratio of 11:5. Elderly EBV-positive DLBCL patients had a higher incidence of non-germinal center B-cell (non-GCB) subtypes (87.5%) and high Ki67 (75%) and CD30 expression (93.8%). For EBV-positive patients undergoing initial chemotherapy, 7 of 16 (43.8%) had complete remission, 2 (12.5%) had partial remission, 2 (12.5%) had stable disease, and 5 (31.3%) had progressive disease. The median overall survival was 9 months for the EBV-positive patients. A matched-case control analysis suggested that EBV-positive patients had inferior survival outcomes compared with EBV-negative patients (3-year progression-free survival [PFS]: 25% vs. 76.7%, respectively; 3-year overall survival [OS]: 25% vs. 77.4%, respectively; P |
| doi_str_mv | 10.1371/journal.pone.0133973 |
| format | Article |
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In situ hybridization (ISH) analysis of Epstein-Barr virus (EBV) and immunohistochemistry was performed in 230 tumor specimens from consecutive de novo DLBCL patients over 50 years old. A matched-case control analysis (1:3) was utilized to compare EBV-positive and EBV-negative DLBCL in the elderly.
A total of 16 patients (7.0%) were diagnosed with EBV-positive DLBCL. Of these 16 cases, the median age was 62 years, with a male to female ratio of 11:5. Elderly EBV-positive DLBCL patients had a higher incidence of non-germinal center B-cell (non-GCB) subtypes (87.5%) and high Ki67 (75%) and CD30 expression (93.8%). For EBV-positive patients undergoing initial chemotherapy, 7 of 16 (43.8%) had complete remission, 2 (12.5%) had partial remission, 2 (12.5%) had stable disease, and 5 (31.3%) had progressive disease. The median overall survival was 9 months for the EBV-positive patients. A matched-case control analysis suggested that EBV-positive patients had inferior survival outcomes compared with EBV-negative patients (3-year progression-free survival [PFS]: 25% vs. 76.7%, respectively; 3-year overall survival [OS]: 25% vs. 77.4%, respectively; P<0.001).
EBV-positive DLBCL of the elderly is associated with an inferior clinical course and inferior survival outcomes. The role of EBV in this disease and the optimal management of this subgroup warrants further investigation.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0133973</identifier><identifier>PMID: 26222726</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Aged ; Aged patients ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; B-cell lymphoma ; Cancer therapies ; Care and treatment ; Case-Control Studies ; CD30 antigen ; Chemotherapy ; Collaboration ; Cyclophosphamide - therapeutic use ; Diagnosis ; Disease control ; Doxorubicin - therapeutic use ; Epstein-Barr virus ; Epstein-Barr virus diseases ; Etoposide - therapeutic use ; Female ; Gene expression ; Geriatrics ; Herpesvirus 4, Human - physiology ; Humans ; Hybridization ; Immunohistochemistry ; Infections ; Kinases ; Laboratories ; Lymphocytes B ; Lymphoma ; Lymphoma, Large B-Cell, Diffuse - drug therapy ; Lymphoma, Large B-Cell, Diffuse - metabolism ; Lymphoma, Large B-Cell, Diffuse - pathology ; Lymphoma, Large B-Cell, Diffuse - virology ; Lymphomas ; Male ; Medical prognosis ; Medicine ; Middle Aged ; Older people ; Oncology ; Patients ; Physiological aspects ; Prednisone - therapeutic use ; Remission ; Retrospective Studies ; Survival ; Survival Analysis ; Treatment Outcome ; Tumors ; Vincristine - therapeutic use ; Viruses</subject><ispartof>PloS one, 2015-07, Vol.10 (7), p.e0133973-e0133973</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Song et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Song et al 2015 Song et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-6e483942b722784f52529026f0e979834b5661cff40c962ad89a4a28fad7dca03</citedby><cites>FETCH-LOGICAL-c692t-6e483942b722784f52529026f0e979834b5661cff40c962ad89a4a28fad7dca03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4519250/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4519250/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26222726$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Song, Chen-Ge</creatorcontrib><creatorcontrib>Huang, Jia-Jia</creatorcontrib><creatorcontrib>Li, Ya-Jun</creatorcontrib><creatorcontrib>Xia, Yi</creatorcontrib><creatorcontrib>Wang, Yu</creatorcontrib><creatorcontrib>Bi, Xi-Wen</creatorcontrib><creatorcontrib>Jiang, Wen-Qi</creatorcontrib><creatorcontrib>Huang, Hui-Qiang</creatorcontrib><creatorcontrib>Lin, Tong-Yu</creatorcontrib><creatorcontrib>Li, Zhi-Ming</creatorcontrib><title>Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma in the Elderly: A Matched Case-Control Analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) in the elderly has rarely been reported. This study aimed to explore the clinical characteristics and prognosis of this entity.
In situ hybridization (ISH) analysis of Epstein-Barr virus (EBV) and immunohistochemistry was performed in 230 tumor specimens from consecutive de novo DLBCL patients over 50 years old. A matched-case control analysis (1:3) was utilized to compare EBV-positive and EBV-negative DLBCL in the elderly.
A total of 16 patients (7.0%) were diagnosed with EBV-positive DLBCL. Of these 16 cases, the median age was 62 years, with a male to female ratio of 11:5. Elderly EBV-positive DLBCL patients had a higher incidence of non-germinal center B-cell (non-GCB) subtypes (87.5%) and high Ki67 (75%) and CD30 expression (93.8%). For EBV-positive patients undergoing initial chemotherapy, 7 of 16 (43.8%) had complete remission, 2 (12.5%) had partial remission, 2 (12.5%) had stable disease, and 5 (31.3%) had progressive disease. The median overall survival was 9 months for the EBV-positive patients. A matched-case control analysis suggested that EBV-positive patients had inferior survival outcomes compared with EBV-negative patients (3-year progression-free survival [PFS]: 25% vs. 76.7%, respectively; 3-year overall survival [OS]: 25% vs. 77.4%, respectively; P<0.001).
EBV-positive DLBCL of the elderly is associated with an inferior clinical course and inferior survival outcomes. The role of EBV in this disease and the optimal management of this subgroup warrants further investigation.</description><subject>Age</subject><subject>Aged</subject><subject>Aged patients</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>B-cell lymphoma</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Case-Control Studies</subject><subject>CD30 antigen</subject><subject>Chemotherapy</subject><subject>Collaboration</subject><subject>Cyclophosphamide - therapeutic use</subject><subject>Diagnosis</subject><subject>Disease control</subject><subject>Doxorubicin - therapeutic use</subject><subject>Epstein-Barr virus</subject><subject>Epstein-Barr virus diseases</subject><subject>Etoposide - therapeutic use</subject><subject>Female</subject><subject>Gene expression</subject><subject>Geriatrics</subject><subject>Herpesvirus 4, Human - physiology</subject><subject>Humans</subject><subject>Hybridization</subject><subject>Immunohistochemistry</subject><subject>Infections</subject><subject>Kinases</subject><subject>Laboratories</subject><subject>Lymphocytes B</subject><subject>Lymphoma</subject><subject>Lymphoma, Large B-Cell, Diffuse - drug therapy</subject><subject>Lymphoma, Large B-Cell, Diffuse - metabolism</subject><subject>Lymphoma, Large B-Cell, Diffuse - pathology</subject><subject>Lymphoma, Large B-Cell, Diffuse - virology</subject><subject>Lymphomas</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Older people</subject><subject>Oncology</subject><subject>Patients</subject><subject>Physiological aspects</subject><subject>Prednisone - therapeutic use</subject><subject>Remission</subject><subject>Retrospective Studies</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Vincristine - therapeutic use</subject><subject>Viruses</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk1tv0zAUxyMEYmPwDRBEQkLwkOJb7HgPSF0pUKloiMteLddxGk9OXGxnot8el2ZTi_aA_GDr-Hf-52KfLHsOwQRiBt9du8H30k42rtcTADHmDD_ITiHHqKAI4IcH55PsSQjXAJS4ovRxdoIoQoghepqZ-SZEbfriQnqfXxk_hOKrCyaaG51_ME0zBJ0vpV_r_KKYaWvz5bbbtK6Tuenz2Op8bmvt7fY8n-ZfZFStrvOZDLqYuT56Z_NpSnIbTHiaPWqkDfrZuJ9lPz_Of8w-F8vLT4vZdFkoylEsqCYV5gStWMqwIk2JSsQBog3QnPEKk1VJKVRNQ4DiFMm64pJIVDWyZrWSAJ9lL_e6G-uCGLsUBGQAQMBKyhKx2BO1k9di400n_VY4acRfg_NrIX00ymoBAa4xBLVsakBUyaSCjFGe4pR8hWudtN6P0YZVp2ulU9HSHoke3_SmFWt3I0gJOSp36b4ZBbz7NegQRWeCSo2WvXbDPm9aEYJIQl_9g95f3UitZSrA9I1LcdVOVExJWWLKKowSNbmHSqvWnVHpSzUm2Y8c3h45JCbq33EthxDE4vu3_2cvr47Z1wdsq6WNbXB2iMb14Rgke1B5F4LXzV2TIRC7ibjththNhBgnIrm9OHygO6fbEcB_ABX9A_M</recordid><startdate>20150729</startdate><enddate>20150729</enddate><creator>Song, Chen-Ge</creator><creator>Huang, Jia-Jia</creator><creator>Li, Ya-Jun</creator><creator>Xia, Yi</creator><creator>Wang, Yu</creator><creator>Bi, Xi-Wen</creator><creator>Jiang, Wen-Qi</creator><creator>Huang, Hui-Qiang</creator><creator>Lin, Tong-Yu</creator><creator>Li, Zhi-Ming</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20150729</creationdate><title>Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma in the Elderly: A Matched Case-Control Analysis</title><author>Song, Chen-Ge ; Huang, Jia-Jia ; Li, Ya-Jun ; Xia, Yi ; Wang, Yu ; Bi, Xi-Wen ; Jiang, Wen-Qi ; Huang, Hui-Qiang ; Lin, Tong-Yu ; Li, Zhi-Ming</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-6e483942b722784f52529026f0e979834b5661cff40c962ad89a4a28fad7dca03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Age</topic><topic>Aged</topic><topic>Aged patients</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>B-cell lymphoma</topic><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>Case-Control Studies</topic><topic>CD30 antigen</topic><topic>Chemotherapy</topic><topic>Collaboration</topic><topic>Cyclophosphamide - therapeutic use</topic><topic>Diagnosis</topic><topic>Disease control</topic><topic>Doxorubicin - therapeutic use</topic><topic>Epstein-Barr virus</topic><topic>Epstein-Barr virus diseases</topic><topic>Etoposide - therapeutic use</topic><topic>Female</topic><topic>Gene expression</topic><topic>Geriatrics</topic><topic>Herpesvirus 4, Human - physiology</topic><topic>Humans</topic><topic>Hybridization</topic><topic>Immunohistochemistry</topic><topic>Infections</topic><topic>Kinases</topic><topic>Laboratories</topic><topic>Lymphocytes B</topic><topic>Lymphoma</topic><topic>Lymphoma, Large B-Cell, Diffuse - drug therapy</topic><topic>Lymphoma, Large B-Cell, Diffuse - metabolism</topic><topic>Lymphoma, Large B-Cell, Diffuse - pathology</topic><topic>Lymphoma, Large B-Cell, Diffuse - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Song, Chen-Ge</au><au>Huang, Jia-Jia</au><au>Li, Ya-Jun</au><au>Xia, Yi</au><au>Wang, Yu</au><au>Bi, Xi-Wen</au><au>Jiang, Wen-Qi</au><au>Huang, Hui-Qiang</au><au>Lin, Tong-Yu</au><au>Li, Zhi-Ming</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma in the Elderly: A Matched Case-Control Analysis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-07-29</date><risdate>2015</risdate><volume>10</volume><issue>7</issue><spage>e0133973</spage><epage>e0133973</epage><pages>e0133973-e0133973</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) in the elderly has rarely been reported. This study aimed to explore the clinical characteristics and prognosis of this entity.
In situ hybridization (ISH) analysis of Epstein-Barr virus (EBV) and immunohistochemistry was performed in 230 tumor specimens from consecutive de novo DLBCL patients over 50 years old. A matched-case control analysis (1:3) was utilized to compare EBV-positive and EBV-negative DLBCL in the elderly.
A total of 16 patients (7.0%) were diagnosed with EBV-positive DLBCL. Of these 16 cases, the median age was 62 years, with a male to female ratio of 11:5. Elderly EBV-positive DLBCL patients had a higher incidence of non-germinal center B-cell (non-GCB) subtypes (87.5%) and high Ki67 (75%) and CD30 expression (93.8%). For EBV-positive patients undergoing initial chemotherapy, 7 of 16 (43.8%) had complete remission, 2 (12.5%) had partial remission, 2 (12.5%) had stable disease, and 5 (31.3%) had progressive disease. The median overall survival was 9 months for the EBV-positive patients. A matched-case control analysis suggested that EBV-positive patients had inferior survival outcomes compared with EBV-negative patients (3-year progression-free survival [PFS]: 25% vs. 76.7%, respectively; 3-year overall survival [OS]: 25% vs. 77.4%, respectively; P<0.001).
EBV-positive DLBCL of the elderly is associated with an inferior clinical course and inferior survival outcomes. The role of EBV in this disease and the optimal management of this subgroup warrants further investigation.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26222726</pmid><doi>10.1371/journal.pone.0133973</doi><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_1700107567 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Age Aged Aged patients Antineoplastic Combined Chemotherapy Protocols - therapeutic use B-cell lymphoma Cancer therapies Care and treatment Case-Control Studies CD30 antigen Chemotherapy Collaboration Cyclophosphamide - therapeutic use Diagnosis Disease control Doxorubicin - therapeutic use Epstein-Barr virus Epstein-Barr virus diseases Etoposide - therapeutic use Female Gene expression Geriatrics Herpesvirus 4, Human - physiology Humans Hybridization Immunohistochemistry Infections Kinases Laboratories Lymphocytes B Lymphoma Lymphoma, Large B-Cell, Diffuse - drug therapy Lymphoma, Large B-Cell, Diffuse - metabolism Lymphoma, Large B-Cell, Diffuse - pathology Lymphoma, Large B-Cell, Diffuse - virology Lymphomas Male Medical prognosis Medicine Middle Aged Older people Oncology Patients Physiological aspects Prednisone - therapeutic use Remission Retrospective Studies Survival Survival Analysis Treatment Outcome Tumors Vincristine - therapeutic use Viruses |
| title | Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma in the Elderly: A Matched Case-Control Analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T12%3A20%3A26IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Epstein-Barr%20Virus-Positive%20Diffuse%20Large%20B-Cell%20Lymphoma%20in%20the%20Elderly:%20A%20Matched%20Case-Control%20Analysis&rft.jtitle=PloS%20one&rft.au=Song,%20Chen-Ge&rft.date=2015-07-29&rft.volume=10&rft.issue=7&rft.spage=e0133973&rft.epage=e0133973&rft.pages=e0133973-e0133973&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0133973&rft_dat=%3Cgale_plos_%3EA455367832%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1700107567&rft_id=info:pmid/26222726&rft_galeid=A455367832&rft_doaj_id=oai_doaj_org_article_103d310dafd04c57ac17769ca059b3de&rfr_iscdi=true |