Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA.
Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
Leuk Lymphoma. 2023 May;64(5):1026-1034. doi: 10.1080/10428194.2023.2191152. Epub 2023 Mar 24.
The objective of this multicenter retrospective study was to examine the incidence, patient characteristics, pathology, and outcomes associated with Epstein-Barr virus (EBV)-related CNS lymphoma (CNSL) in older patients. Among 309 CNSL patients aged ≥60, 11.7% had EBV + tumors of which 72.2% were solid organ transplant (SOT)-related post-transplant lymphoproliferative disorders (PTLD). Younger age, SOT or autoimmune disease, and immunosuppressive treatment correlated highly with EBV-positivity. EBV + tumors were associated with absent C-MYC and BCL6 expression. EBV + PTLD was more likely to be associated with the absence of CD5 expression. EBV + non-PTLD had better median OS (not reached) compared to EBV + PTLD (10.8 months) and EBV-negative patients (43 months). Multivariable Cox regression analysis showed that age, performance status, and PTLD were negative predictors of OS. EBV status and immunosuppressive treatment were not correlated with OS. Our findings merit further investigation of EBV + PCNSL tumors and EBV-directed therapies.
本多中心回顾性研究的目的是探讨老年患者中与 Epstein-Barr 病毒 (EBV) 相关的中枢神经系统淋巴瘤 (CNSL) 的发生率、患者特征、病理学和结局。在 309 名年龄≥60 岁的 CNSL 患者中，11.7% 的患者存在 EBV+肿瘤，其中 72.2% 为实体器官移植 (SOT) 相关的移植后淋巴组织增生性疾病 (PTLD)。年龄较小、SOT 或自身免疫性疾病以及免疫抑制治疗与 EBV 阳性高度相关。EBV+肿瘤与 C-MYC 和 BCL6 表达缺失相关。与 EBV−患者相比，EBV+PTLD 更易与 CD5 表达缺失相关。与 EBV−患者相比，EBV+非-PTLD 的中位 OS 更好（未达到）。与 EBV+PTLD（10.8 个月）和 EBV−患者（43 个月）相比。多变量 Cox 回归分析表明，年龄、表现状态和 PTLD 是 OS 的负预测因素。EBV 状态和免疫抑制治疗与 OS 无关。我们的研究结果值得进一步研究 EBV+PCNSL 肿瘤和 EBV 靶向治疗。
