Impact of Epstein-Barr Virus on Peripheral T-Cell Lymphoma Not Otherwise Specified and Angioimmunoblastic T-Cell Lymphoma

Abstract

PurposeThe significance of Epstein-Barr virus (EBV) infections for the prognosis of patients with peripheral T-cell lymphomas (PTCLs), specifically angioimmunoblastic T-cell lymphoma (AITL) and PTCL not otherwise specified (PTCL-NOS), remains unclear. The Epstein-Barr encoding region can be used to detect EBV in tissue sections by in situ hybridization (ISH) and by polymerase chain reaction (PCR) assays of peripheral blood samples from patients with PTCLs. This study compared the outcomes patients with AITL or PTCL-NOS for whom the presence of EBV infection was assessed by these two methods.Patients and MethodsThis was a retrospective study of patients newly diagnosed with AITL or PTCL-NOS. All patients were selected from a single transplantation center. EBV-positive lymphomas were detected at the time of diagnosis in tissue sections by ISH or in the blood by PCR.ResultsOut of a cohort of 140 patients with histologically confirmed AITL or PTCL-NOS, 105 were EBV-positive. The 3-year overall survival of patients with EBV-positive TCL was 43.3% compared to 68.6% in patients with EBV-negative TCL (p = .01). Patients who were treated with autologous or allogeneic hematopoietic stem cell transplantation (n = 28 and n = 11, respectively) or chemotherapy alone (n = 66) had 3-year survival rates of 67.0%, 62.3%, and 30.2%, respectively (p <.02). Patients with EBV-positive TCL had a better prognosis after treatment with hematopoietic stem cell transplantation compared to chemotherapy alone, but no difference was seen among patients with EBV-negative TCL.ConclusionsEBV infection was shown to negatively affect the clinical outcomes of patients with TCL. Stem cell transplantation has been found to be an effective treatment for EBV-associated lymphomas. Further investigations are warranted to determine the optimal treatment for these patients.

Clinical features and prognosis of acute lymphoblastic leukemia in children with Epstein-Barr virus infection

“…The results of this paper showed that the highest percentage of first symptoms were hepatosplenic lymph node enlargement in infected patients compared to non-EBV infected children, which further supports the conclusion that EBV infection can cause hepatosplenomegaly and is consistent with the characteristics of this virus. It has been shown (20,21) that EBV primarily infects B lymphocytes by viral glycoprotein binding to complement receptors on the surface of B lymphocytes. The results of this paper found that EBV infection was associated with the immunophenotype of the children, with the number of B-cell type cases being higher than the T-cell type in the infected group, which further suggests that the target cells of EBV are B-cells.…”

Role of plasma EBV-DNA load and EBER status on newly diagnosed peripheral T-cell lymphoma

“…DNA was extracted from plasma samples using the EBV PCR Fluorescence Quantitative Diagnostic Kit. Copy numbers were analyzed using a standard curve, with 500 copies/mL defined as the critical value based on previous studies (Kim et al 2021 ; Shen et al 2022 ; Zeng et al 2022 ; Qiu et al 2022 ). If EBV DNA was less than 500 copies/mL, it was recorded as 0.…”

“…However, the effect of EBV on PTCL remains controversial. Some studies (Dupuis et al 2006 ; Weisenburger et al 2011 ; Kim et al 2021 ) have demonstrated poor survival outcomes in patients with EBV infection, while others have presented contrary views (Haverkos et al 2017 ; Shen et al 2022 ). Additionally, only a few studies have compared different EBV detection methods, such as EBER using in situ hybridization (ISH) in neoplasms and EBV DNA polymerase gene in peripheral blood using polymerase chain reaction (PCR) (Kim et al 2021 ; Shen et al 2022 ; Zeng et al 2022 ).…”

PTCL, NOS: An update on classification, risk-stratification, and treatment

“…With the possible exception of PTLD, EBV more commonly affects B-cells within the tumor microenvironment, and rarely infects malignant T cells, at least in the West ( 14 ). However, EBV associated PTCL, NOS is more common in Asia, where EBV infection is associated with inferior outcomes ( 20 ). While previously classified as a subtype of PTCL, NOS, in the current WHO classification these lymphomas are now classified as nodal EBV-positive T and NK-cell lymphomas ( 4 ).…”