Clinical characteristics and prognostic significance of EBER positivity in diffuse large B-cell lymphoma: A meta-analysis

Abstract

Recent studies show that Epstein-Barr virus (EBV) positivity might be related to adverse prognosis in patients with diffuse large B-cell lymphoma (DLBCL), but the results are still inconclusive. We conducted this meta-analysis to define the clinical value of EBV infection in DLBCL. All potential articles in PubMed, Web of Science, Medline, and Embase were retrieved. Using the random-effects or fixed-effect model, pooled hazard ratios (HRs) or relative risk (RR) with 95% confidence intervals (CIs) were used to calculate the correlation between EBER and prognosis and clinical features in DLBCL. A total of 13 qualified studies with 4111 patients were identified in our meta-analysis based on the inclusion and exclusion criteria. The overall estimates revealed that EBV-encoded small RNAs (EBER) positivity was significantly correlated with worse overall survival (HR = 2.43, 95% CI: 1.73–3.36) and progression-free survival (HR = 3.60, 95% CI: 2.07–6.26). In addition, EBER positivity was associated with age older than 60 years (RR = 1.51, 95% CI: 1.02–2.24), male sex (RR = 1.34, 95% CI: 1.05–1.71), more advanced stage (RR = 2.25, 95% CI: 1.72–2.96), high international prognostic index (RR = 2.20, 95% CI: 1.71–2.82), more than one extranodal involvement (RR = 1.69, 95% CI: 1.27–2.26), presence of B symptom (RR = 1.75, 95% CI: 1.30–2.35), non-germinal center B-cell subtype (RR = 1.35, 95% CI: 1.03–1.78), and elevated lactate dehydrogenase levels (RR = 1.30, 95% CI: 0.98–1.72). EBER positivity was correlated with worse outcomes, worse clinical course, and adverse clinicopathologic features among patients with DLBCL.

Impact of treatment variability and clinicopathological characteristics on survival in patients with Epstein‐Barr‐Virus positive diffuse large B cell lymphoma

“…Unlike a recent report by Gao et al . we found our cohort of EBV + DLBCL (NOS) not be enriched for presence of B symptoms, which were a strong prognosticator in terms of both PFS and OS (Gao et al , ). This may well be attributed to the fact that prior investigations were not restricted to a specific subtype of NHL.…”

Nasopharyngeal Lymphoma: A 22-Year Review of 35 Cases

“…Lymphoma, the most common non-epithelial malignancy of the head and neck region, can be classified into two types, Hodgkin’s lymphoma (HL) and non-Hodgkin’s lymphoma (NHL) [1]. Among them, primary nasopharyngeal (NP) lymphoma is a very rare tumor, with only limited studies found in the literatures [2,3,4,5,6,7,8,9,10]. Waldeyer-Hartz firstly described the lymphoid tissues within the nasopharynx, oropharyngeal wall, base of the tongue, palatine tonsils, and soft palate, known today as Waldeyer’s ring (WR) [7].…”

“…EBV-associated viral proteins were found to play important roles in the genesis of lymphomas through several mechanisms [10,14,15,16,17]. The expression of EBV-encoded small RNAs (EBER) is common in NKTCL, while EBER positivity is still controversial in DLBCL [10,18,19,20,21,22]. There are studies reporting that EBER-positive patients have a poorer prognosis than EBER-negative patients [10,23].…”

“…The expression of EBV-encoded small RNAs (EBER) is common in NKTCL, while EBER positivity is still controversial in DLBCL [10,18,19,20,21,22]. There are studies reporting that EBER-positive patients have a poorer prognosis than EBER-negative patients [10,23].…”

Diffuse large B-cell lymphoma of the endometrium: an unusual site for primary presentation

“…1 Epstein-Barr encoding region (EBER) in-situ hybridisation was positive in neoplastic cells, which has been associated with a more aggressive clinical course and worse overall prognosis in diffuse large B-cell lymphoma Figure 1. 2 Amplification of the immunoglobulin heavy chain (IgH) gene by polymerase chain reaction (PCR) confirmed B-cell clonality with FR3 primers. This is indicative of a proliferation of genetically identical cells.…”