Beltran Brady E, Quiñones Pilar, Morales Domingo, Malaga Jose M, Chavez Julio C, Sotomayor Eduardo M, Castillo Jorge J
Department of Oncology and Radiotherapy, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru.
Department of Pathology, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru.
Hematol Oncol. 2018 Feb;36(1):93-97. doi: 10.1002/hon.2449. Epub 2017 Jun 22.
Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) is a haematologic malignancy with poor prognosis when treated with chemotherapy. We evaluated response and survival benefits of chemoimmunotherapy in EBV-positive DLBCL patients. A total of 117 DLBCL patients were included in our retrospective analysis; 33 were EBV-positive (17 treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone [R-CHOP] and 16 with CHOP), and 84 were EBV-negative (all treated with R-CHOP). The outcomes of interest were complete response (CR) and overall survival (OS) in EBV-positive DLBCL patients (R-CHOP versus CHOP) and in DLBCL patients treated with R-CHOP (EBV-positive vs EBV-negative). There were no differences in the clinical characteristics between EBV-positive and EBV-negative DLBCL patients. Among EBV-positive DLBCL patients, R-CHOP was associated with higher odds of CR (OR 3.14, 95% CI 0.75-13.2; P = .10) and better OS (hazard ratio 0.30, 95% confidence interval [CI] 0.09-0.94; P = .04). There were no differences in CR rate (OR 0.52, 95% CI 0.18-1.56; P = .25) or OS (hazard ratio 0.93, 95% CI 0.32-2.67; P = .89) between EBV-positive and EBV-negative DLBCL patients treated with R-CHOP. Based on our study, the addition of rituximab to CHOP is associated with improved response and survival in EBV-positive DLBCL patients. Epstein-Barr virus status does not seem to affect response or survival in DLBCL patients treated with R-CHOP.
爱泼斯坦-巴尔病毒（EBV）阳性弥漫性大B细胞淋巴瘤（DLBCL）是一种血液系统恶性肿瘤，化疗预后较差。我们评估了化疗免疫疗法对EBV阳性DLBCL患者的反应和生存益处。我们的回顾性分析共纳入了117例DLBCL患者；33例为EBV阳性（17例接受利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松[R-CHOP]治疗，16例接受CHOP治疗），84例为EBV阴性（均接受R-CHOP治疗）。关注的结果是EBV阳性DLBCL患者（R-CHOP与CHOP）以及接受R-CHOP治疗的DLBCL患者（EBV阳性与EBV阴性）的完全缓解（CR）和总生存期（OS）。EBV阳性和EBV阴性DLBCL患者的临床特征没有差异。在EBV阳性DLBCL患者中，R-CHOP与更高的CR几率（OR 3.14，95%CI 0.75-13.2；P = 0.10）和更好的OS（风险比0.30，95%置信区间[CI] 0.09-0.94；P = 0.04）相关。接受R-CHOP治疗的EBV阳性和EBV阴性DLBCL患者在CR率（OR 0.52，95%CI 0.18-1.56；P = 0.25）或OS（风险比0.93，95%CI 0.32-2.67；P = 0.89）方面没有差异。基于我们的研究，在CHOP方案中添加利妥昔单抗与改善EBV阳性DLBCL患者的反应和生存相关。EBV状态似乎不影响接受R-CHOP治疗的DLBCL患者的反应或生存。
