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Epstein-Barr virus as a marker of survival after Hodgkin's lymphoma: a population-based study.
- Source :
-
Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2005 Oct 20; Vol. 23 (30), pp. 7604-13. Date of Electronic Publication: 2005 Sep 26. - Publication Year :
- 2005
-
Abstract
- Purpose: Epstein-Barr virus (EBV) in Hodgkin's lymphoma (HL) cells has been considered as a prognostic marker for this heterogeneous disease, but studies have yielded mixed findings, likely because of selected patient series and failure to acknowledge an effect of age on outcome. This study assessed survival after HL in a population-based cohort large enough to examine the joint effects of EBV with other factors including age, sex, and histologic subtype.<br />Patients and Methods: Included were 922 patients with classical HL diagnosed between mid-1988 and 1997 in the Greater San Francisco Bay Area, with archived biopsy specimens assayed for EBV with immunohistochemistry and in situ hybridization. Vital status was followed through December 30, 2003 (median follow-up time, 97 months). Overall and disease-specific survival were analyzed with the Kaplan-Meier method and Cox proportional hazards regression models.<br />Results: In children less than 15 years old, EBV presence was suggestively associated (P = .07) with favorable survival. In adults aged 15 to 44 years, EBV did not affect HL outcome, although a protective effect was suggested. In older adults (45 to 96 years), EBV presence nearly doubled the risk of overall and HL-specific mortality but only for patients with nodular sclerosis (NS) histologic subtype (hazard ratio for death = 2.5; 95% CI, 1.5 to 4.3).<br />Conclusion: In HL, EBV tumor cell presence is associated with better survival in young patients and poorer survival in older patients with NS, independent of other factors. Variation in outcome by age and histology could indicate biologically distinct disease entities. Evidence that EBV is a meaningful prognostic marker may have therapeutic relevance.
- Subjects :
- Adolescent
Adult
Age of Onset
Aged
Aged, 80 and over
Female
Humans
Immunoenzyme Techniques
In Situ Hybridization
Male
Middle Aged
Prognosis
Survival Rate
Biomarkers, Tumor analysis
Epstein-Barr Virus Infections complications
Herpesvirus 4, Human genetics
Herpesvirus 4, Human isolation & purification
Herpesvirus 4, Human pathogenicity
Hodgkin Disease epidemiology
Hodgkin Disease mortality
Hodgkin Disease virology
Subjects
Details
- Language :
- English
- ISSN :
- 0732-183X
- Volume :
- 23
- Issue :
- 30
- Database :
- MEDLINE
- Journal :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 16186595
- Full Text :
- https://doi.org/10.1200/JCO.2005.02.6310