Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.
Department of Clinical laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.
Biosci Rep. 2019 Oct 30;39(10). doi: 10.1042/BSR20190284.
The aim of the present study was to evaluate the relationship of Epstein-Barr virus (EBV) infection and multiple myeloma (MM) and its impact on clinical characteristics and prognosis. Fresh peripheral blood mononuclear cells (PBMCs) from 139 MM patients who had been diagnosed and treated from January 2010 to May 2018 and 50 PBMC samples from healthy donors were obtained. PCR was carried out for detection of EBV-DNA. The results indicated a significantly higher EBV-DNA concentration among 139 MM patients compared with healthy controls (P<0.05). Correlation analysis showed that the expression of EBV-DNA was positively correlated with the serum free light chain ratio (sFLCR) and progressive disease (PD)/relapse (P<0.05). Especially, in EBV-DNA high-expression MM patients, EBV-DNA concentration for patients with sFLCR ≥100 was higher than that of patients with sFLCR <100. EBV-DNA concentration was higher in patients with disease PD/relapse than those without disease PD/relapse. In univariate analysis, the progress free survival (PFS) was inferior in MM patients with high expression of EBV-DNA, high lactate dehydrogenase (LDH), and high-risk according to mSMART and International Myeloma Working Group (IMWG), stage III according to R-ISS staging, extramedullary lesions, and genetic changes (P<0.05). However, in multivariate analysis, LDH, poor karyotype, R-ISS staging, and mSMART were independent prognostic factors for PFS. Taken together, our studies suggest that an association exists between EBV infection and clinical characteristics of MM patients, and EBV infection appears to have a slight impact on the prognosis of MM. However, the results require further validation in other independent prospective MM cohorts.
本研究旨在评估 EBV 感染与多发性骨髓瘤（MM）的关系及其对临床特征和预后的影响。收集了 2010 年 1 月至 2018 年 5 月期间诊断和治疗的 139 例 MM 患者和 50 例健康供者的新鲜外周血单个核细胞（PBMC）。采用 PCR 法检测 EBV-DNA。结果显示，与健康对照组相比，139 例 MM 患者 EBV-DNA 浓度明显升高（P<0.05）。相关性分析显示，EBV-DNA 的表达与血清游离轻链比（sFLCR）和进展性疾病（PD）/复发（P<0.05）呈正相关。特别是在 EBV-DNA 高表达的 MM 患者中，sFLCR≥100 的患者 EBV-DNA 浓度高于 sFLCR<100 的患者。PD/复发患者的 EBV-DNA 浓度高于无 PD/复发患者。单因素分析显示，EBV-DNA 高表达、乳酸脱氢酶（LDH）高、根据 mSMART 和国际骨髓瘤工作组（IMWG）属于高危、根据 R-ISS 分期为 III 期、髓外病变和遗传改变的 MM 患者无进展生存期（PFS）较差（P<0.05）。然而，多因素分析显示，LDH、不良核型、R-ISS 分期和 mSMART 是 PFS 的独立预后因素。综上所述，我们的研究表明 EBV 感染与 MM 患者的临床特征存在关联，并且 EBV 感染似乎对 MM 的预后有轻微影响。然而，这些结果需要在其他独立的前瞻性 MM 队列中进一步验证。
