| Purpose:Epstein-Barr virus(EBV) is a well-known tumor associated virus,which is connected with some types of B cell or T cell non-Hodgkin’s lymphoma(NHL).It plays an important role in development and clinical course of these diseases.The viral load in the patients can be reflected by peripheral blood EBV DNA.Some researches shows that peripheral blood EBV DNA is an important biomarker in clinical evaluation of Epstein-Barr virus associated non-Hodgkin’s lymphoma.This retrospective research was carried out to study the relationship between peripheral blood EBV DNA and clinical response and outcome in patients with Epstein-Barr virus associated NHL.Method:244 NHL patients were collected from Fujian Medical University Union Hospital,from 2010 to 2014.The criteria used to classify NHL were as detailed by the 2008 World Health Organization(WHO) classification of tumors of hematopoietic and lymphoid tissues. Ann Arbor staging system was used for disease staging.International Prognostic Index(IPI) was applied to risk stratification for those older than 60 years of age,and age-adjusted IPI(aal PI) for those younger than 60 years of age.The following clinical information was analyzed:age,sex,type of non-hodgkin’s lymphoma,Ann Arbor phase,bone marrow infiltration,extranodal extension disease,blood lactate dehydrogenase(LDH),IPI,lymphoma B symptoms and peripheral blood EBV DNA at the time of diagnosis and after treatment.EBV infection,the relationship between EBV-DNA and NHL clinical adverse prognostic factors,complications and prognosis were analyzed in different types of NHL patients.In statistical analysis,the Chi-squared test was applied to detect differences between two groups,and the method of Kaplan-Meier was used for survival analysis.The Log-rank test was used for survival curve test,and the Cox’s proportional hazards regression model was uesd for multiple prognostic factor analysis.All statistical significance were on the basis of 0.05.Calculations were performed by SPSS version 21.0 for Windows.Result:The most common types of Epstein-Barr virus associated NHL were Burkitt lymphoma,elderly diffuse large B-cell lymphoma(DLBCL),extranodal NK/T-cell lymphoma(ENKTL) and some of peripheral T-cell lymphoma(PTCL).In total 244 NHLcases,peripheral blood EBV-DNA was detected in 34.4% patients.EBV infection in the type of T/NK cell is significantly higher than that is the type of B cells(55.7% vs 22.4%,P<0.05).The patients with peripheral blood EBV-DNA positive at diagnosis has more adverse prognosis factors than those were negative.Detection of peripheral blood Epstein-Barr virus DNA has a certain value in clinical diagnosis and prognosis prediction of NHL complications,like hemophagocytic syndrome(HPS) and post-transplant lymphoproliferative diseases(PTLD).Peripheral blood EBV-DNA copy number could reflect the tumor load in vivo and be use for predicting the prognosis.The 3-year overall survival(OS) of patients with peripheral blood EBV-DNA positive is poorer than of those were negative.In patients with ENKTL,they were 25.7% and 71.4% respectively(P=0.020).In patients with Peripheral T-cell lymphoma not otherwise specified(PTCL.NOS) and Angioimmunoblastic T-cell lymphoma(AICL),they were 48.6% and 85.7% respectively(P=0.033).In patients with DLBCL,they were 65.8% and 81.9% respectively(P=0.118).When the disease is in remission after treatment, peripheral blood EBV-DNA copy usually decrease or turn negative.On the contrast,if the disease progressed or relapsed,peripheral blood EBV-DNA copy always increased significantly.Conclusion:Peripheral blood Epstein-Barr virus DNA is an important biomarker in clinical evaluation of treatment response and outcome in Epstein-Barr virus associated non-Hodgkin’s lymphoma,and should be routine detected in clinical practice. |
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