Chan Chu-Yi, Lin Tung-Liang, Kuo Ming-Chung, Hung Yu-Shin, Chang Hung, Ou Che-Wei, Wu Jin-Hou, Shih Hsuan-Jen, Su Yi-Jiun, Shih Lee-Yung, Ong Yuen-Chin, Chuang Wen-Yu, Kao Hsiao-Wen
Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Ann Med. 2025 Dec;57(1):2478315. doi: 10.1080/07853890.2025.2478315. Epub 2025 Mar 20.
Plasma Epstein-Barr virus (EBV) DNA levels predict the prognosis of extranodal NK/T-cell lymphoma, nasal type (NK/TCL), but its role in other peripheral T-cell lymphomas (PTCL) remains undetermined. This study aimed to determine the prognostic impact of plasma EBV DNA in PTCL patients.
We retrospectively enrolled 134 PTCL patients diagnosed between April 2008 and March 2022, with plasma EBV DNA data available at diagnosis in 124 patients and during post-treatment follow-up in 73 patients.
International Prognostic Index or prognostic index for T-cell lymphoma scores > 1 was associated with higher median plasma EBV DNA levels in all analyzed patients. Plasma EBV DNA positivity at the time of diagnosis was not associated with treatment response, overall survival (OS), or progression-free survival (PFS) in non-NK/TCL patients. In NK/TCL patients, an EBV DNA level < 3255 copies/mL at diagnosis was significantly associated with higher five-year PFS (64.2% vs. 16.7%, < 0.001) and OS rates (64.4% vs. 20.8%, < 0.001). Plasma EBV DNA positivity at the time of complete remission and during post-treatment follow-up was significantly linked to lower PFS and OS rates in NK/TCL patients. Multivariate analysis revealed that advanced-stage disease, elevated β2-microglobulin, and EBV DNA level ≥ 3255 copies/mL at diagnosis were independent predictors for OS and PFS in NK/TCL patients.
Plasma EBV DNA at diagnosis and during follow-up predict survival for NK/TCL patients but not for patients with other PTCL subtypes. Detection and monitoring of plasma EBV DNA levels at diagnosis and post-treatment follow-up for NK/TCL patients is recommended.
血浆 Epstein-Barr 病毒（EBV）DNA 水平可预测鼻型结外 NK/T 细胞淋巴瘤（NK/TCL）的预后，但其在其他外周 T 细胞淋巴瘤（PTCL）中的作用仍未明确。本研究旨在确定血浆 EBV DNA 对 PTCL 患者的预后影响。
我们回顾性纳入了 2008 年 4 月至 2022 年 3 月期间诊断的 134 例 PTCL 患者，其中 124 例患者在诊断时可获得血浆 EBV DNA 数据，73 例患者在治疗后随访期间可获得该数据。
在所有分析的患者中，国际预后指数或 T 细胞淋巴瘤预后指数评分>1 与较高的血浆 EBV DNA 中位数水平相关。在非 NK/TCL 患者中，诊断时血浆 EBV DNA 阳性与治疗反应、总生存期（OS）或无进展生存期（PFS）无关。在 NK/TCL 患者中，诊断时 EBV DNA 水平<3255 拷贝/mL 与较高的五年 PFS（64.2% 对 16.7%，<0.001）和 OS 率（64.4% 对 20.8%，<0.001）显著相关。NK/TCL 患者在完全缓解时及治疗后随访期间血浆 EBV DNA 阳性与较低的 PFS 和 OS 率显著相关。多因素分析显示，晚期疾病、β2-微球蛋白升高以及诊断时 EBV DNA 水平≥3255 拷贝/mL 是 NK/TCL 患者 OS 和 PFS 的独立预测因素。
诊断时及随访期间的血浆 EBV DNA 可预测 NK/TCL 患者的生存，但不能预测其他 PTCL 亚型患者的生存。建议对 NK/TCL 患者在诊断时及治疗后随访期间检测和监测血浆 EBV DNA 水平。
