Pediatric Hodgkin Lymphoma in 2 South American Series: A Distinctive Epidemiologic Pattern and Lack of Association of Epstein-Barr Virus With Clinical Outcome

Abstract

Hodgkin lymphoma (HL) shows a bimodal distribution with a first peak in developing countries during childhood. The causative role and prognostic significance of Epstein-Barr virus (EBV) association in patients with HL is controversial. Our aim was to perform a comparative study of EBV association in 2 Latin American pediatric HL series, and to correlate it with patient's survival. Epstein-Barr encoded RNAs in situ hybridization and latent membrane protein 1 immunohistochemistry were performed on formalin-fixed, paraffin-embedded HL biopsies from 176 pediatric patients from 2 public institutions from Argentina and Southeast Brazil. Mixed cellularity subtype was prevalent in Argentine HL (Arg HL) (52%) and nodular sclerosis subtype in Brazilian HL (BR HL) (83%). EBV expression was detected in 52% of cases, namely 54% Arg HL and 48% Br HL. EBV was significantly associated with mixed cellularity subtype in both populations. In Arg HL, EBV positivity was significantly higher in patients<or=10 years (P=0.0011). Event-free survival did not attain statistical significance neither in Arg HL (P=0.5317), nor in Br HL (P=0.8321). Our results do not support EBV association stated for pediatric HL in developing countries. Correlation of younger age with EBV infection only in Argentine patients might be related to a different age background. In our pediatric series, EBV status cannot be used as prognostic factor.

Incidence of Childhood Hodgkin Lymphoma in Mexico by Histologic Subtypes and Socioeconomic Regions

“…Previous studies have shown a high positive frequency of EBV in ReedSternberg cells in the MC subtype of HL. 30,31 A greater degree of seropositivity for EBV has also been found both in the population of younger children in developing countries and in migrant populations in developed countries, in contradistinction to more developed countries where EBV infection usually occurs later in life. 8,32 At present, to our knowledge, there has been no study in Mexico to determine the timing of the primary infection with EBV.…”

Epstein–Barr virus and Hodgkin’s lymphoma in Cairo, Egypt

“…The age of the children studied was also important, as shown by Zhou et al [30] in China and by Preciado et al [54] in Argentina. In pediatric cases of HL, Chabay et al [58] reported a predominance of the MC subtype (52%) in children in 54 cases of HL from Argentina, in contrast to the NS subtype being the major subtype (83%) in 48 cases of HL from Brazil, and indicated that most of the cases were EBV-positive in both countries.…”

Characteristics of Hodgkin Lymphoma in a Defined Group of Iranian Pediatric Patients

“…In addition, Bazzeh et al showed that the nodular sclerosis (NS) subtype was significantly more common in pediatric age group (Bazzeh et al, 2010). Chabay et al reported the same findings also (Chabay et al, 2008).…”