Sato Ai, Nakamura Naoya, Kojima Minoru, Ohmachi Ken, Carreras Joaquim, Kikuti Yara Yukie, Numata Hiroki, Ohgiya Daisuke, Tazume Kei, Amaki Jun, Moriuchi Makiko, Miyamoto Mitsuki, Aoyama Yasuyuki, Kawai Hidetsugu, Ichiki Akifumi, Hara Ryujiro, Kawada Hiroshi, Ogawa Yoshiaki, Ando Kiyoshi
Department of Hematology-Oncology, School of Medicine, Tokai University, Isehara, Japan.
Cancer Sci. 2014 Sep;105(9):1170-5. doi: 10.1111/cas.12467. Epub 2014 Sep 8.
Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of malignant lymphoma. The incidence of Epstein-Barr virus (EBV)-positive DLBCL in Asian and Latin American countries ranges from 8 to 10%. The prognosis of patients with EBV-positive DLBCL is controversial. To compare the clinical outcome of EBV-positive and EBV-negative patients with DLBCL in the rituximab era, we analyzed 239 patients with de novo DLBCL diagnosed between January 2007 and December 2011. The presence of EBV in lymphoma cells was detected using EBV-encoded RNA in situ hybridization, and it was found that 18 (6.9%) of 260 patients with diagnosed DLBCL tested positive. Among the 260 cases, 216 cases were treated with rituximab plus chemotherapy, as were 8 EBV-positive DLBCL patients. The median overall survival and progression-free survival times in patients with EBV-positive DLBCL were 8.7 months and 6.8 months, respectively. The median overall survival and progression-free survival could not be determined in EBV-negative DLBCL patients (P = 0.0002, P < 0.0001, respectively). The outcome of patients with EBV-positive DLBCL remains poor, even in the rituximab era.
弥漫性大B细胞淋巴瘤（DLBCL）是恶性淋巴瘤最常见的亚型。在亚洲和拉丁美洲国家，爱泼斯坦-巴尔病毒（EBV）阳性的DLBCL发病率为8%至10%。EBV阳性DLBCL患者的预后存在争议。为了比较利妥昔单抗时代EBV阳性和EBV阴性DLBCL患者的临床结局，我们分析了2007年1月至2011年12月期间诊断为初治DLBCL的239例患者。使用EBV编码RNA原位杂交检测淋巴瘤细胞中EBV的存在，发现260例诊断为DLBCL的患者中有18例（6.9%）检测呈阳性。在这260例病例中，216例接受了利妥昔单抗联合化疗，8例EBV阳性DLBCL患者也是如此。EBV阳性DLBCL患者的中位总生存期和无进展生存期分别为8.7个月和6.8个月。EBV阴性DLBCL患者的中位总生存期和无进展生存期无法确定（分别为P = 0.0002，P < 0.0001）。即使在利妥昔单抗时代，EBV阳性DLBCL患者的结局仍然很差。
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