Oncotarget

Research Papers:

Pretreatment Epstein-Barr virus DNA in whole blood is a prognostic marker in peripheral T-cell lymphoma

Yu Ri Kim, Soo-Jeong Kim, June-Won Cheong, Haerim Chung, Ji Eun Jang, Yundeok Kim, Woo-Ick Yang, Yoo Hong Min and Jin Seok Kim _

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Oncotarget. 2017; 8:92312-92323. https://doi.org/10.18632/oncotarget.21251

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Abstract

Yu Ri Kim1, Soo-Jeong Kim2, June-Won Cheong2, Haerim Chung2, Ji Eun Jang2, Yundeok Kim2, Woo-Ick Yang3, Yoo Hong Min2 and Jin Seok Kim2

1Division of Hematology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea

2Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea

3Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea

Correspondence to:

Jin Seok Kim, email: [email protected]

Keywords: peripheral T-cell lymphoma, Epstein-Barr virus, whole blood, prognostic score

Received: July 25, 2017     Accepted: August 23, 2017     Published: September 23, 2017

ABSTRACT

Because there are few studies regarding the clinical impact of circulating EBV-DNA in peripheral T-cell lymphomas (PTCLs), we tried to evaluate the role of EBV-DNA in whole blood as a prognostic factor for PTCL. We retrospectively reviewed 110 PTCL patients with median age of 63 (20-94) years. Forty-seven patients (42.7%) showed positive results for EBV-DNA, and these patients also had stage III/IV disease, elevated lactic dehydrogenase, and low albumin level (P = 0.007, P = 0.004, P = 0.002, respectively). The 5-year overall survival (OS) and progression free survival (PFS) were 21.0% and 18.0%. Univariable analysis showed that positive EBV-DNA was related with inferior OS and PFS (P = 0.015 and P < 0.001, respectively). Multivariable analysis showed that poor performance status, extranodal involvement more than one site and positive EBV-DNA results were related with OS and PFS (P < 0.001, P < 0.001, P = 0.007 and P = 0.001, P = 0.002, P < 0.001, respectively). Using these three variables, we made a new prognostic model which classified patients on risk as follows: low, no adverse factors; intermediate, 1 factor; or high, 2-3 factors. The new prognostic model could stratify the three groups for OS and PFS better than either international prognostic index or prognostic index of PTCL-u, and showed statistical significance in PTCL, not otherwise specified. This study suggests that whole blood EBV-DNA is related with aggressive clinical characteristics and inferior survival. The new prognostic model, which incorporates EBV-DNA, could better stratify PTCL patients.


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