Indian Pediatrics

, Volume 52, Issue 8, pp 681–685 | Cite as

Plasma Epstein-Barr virus (EBV) DNA as a biomarker for EBV-associated Hodgkin lymphoma

  • Veronique Dinand
  • Anupam Sachdeva
  • Sanghamitra Datta
  • Sunita Bhalla
  • Manas Kalra
  • Chand Wattal
  • Nita Radhakrishnan
Research Paper

Abstract

Objectives

To assess plasma Epstein-Barr virus (EBV) DNA as a biomarker of tumour burden at diagnosis and during therapy in children with Hodgkin lymphoma.

Design

Case-control study, with prospective follow-up of the Hodgkin lymphoma cohort (2007-2012).

Setting

Pediatric Hematology Oncology unit of a tertiary care hospital in Delhi.

Patients

Thirty children with Hodgkin lymphoma and 70 sex and age-matched controls (benign lymphadenopathy 19, non-lymphoid malignancy 29, Burkitt lymphoma 5, healthy children 17).

Intervention

Positive EBV-staining on immunohistochemistry was defined as EBV-associated Hodgkin lymphoma. Plasma EBV real-time quantitative polymerase chain reaction (PCR) was tested at presentation, after first and last chemotherapy cycles, and on follow-up.

Main outcome measures

Plasma EBV quantitative PCR was compared between cases and controls. Its kinetics was assessed during and after chemotherapy.

Results

Results: EBV quantitative PCR was positive in 19 (63%) Hodgkin lymphoma cases (range 500–430,000 copies/mL), with 87.5% accuracy (kappa=0.69) as compared with EBVimmunohistochemistry. Sensitivity and specificity of the quantitative PCR were 87.5% and 81.8%, respectively. Only boys showed positive EBV immunohistochemistry and/or quantitative- PCR positivity. All controls were quantitative-PCR negative. All quantitative-PCR positive cases with follow-up blood sample showed EBV clearance after the first cycle. A quantitative-PCR negative case in long-term remission became positive at relapse. EBV status did not influence survival.

Conclusion

Plasma EBV-DNA, detectable in EBV-associated Hodgkin lymphoma, becomes undetectable early after initiating therapy. It can be used as a biomarker of treatment response in EBV-associated Hodgkin lymphoma.

Keywords

Follow-up Immuno-histochemistry Outcome 

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Copyright information

© Indian Academy of Pediatrics 2015

Authors and Affiliations

  • Veronique Dinand
    • 1
  • Anupam Sachdeva
    • 1
  • Sanghamitra Datta
    • 2
  • Sunita Bhalla
    • 3
  • Manas Kalra
    • 1
  • Chand Wattal
    • 2
  • Nita Radhakrishnan
    • 1
  1. 1.Pediatric Hematology, Oncology and BMT Unit, Department of Pediatrics, Institute of Child HealthSir Ganga Ram HospitalDelhiIndia
  2. 2.Department of Clinical Microbiology & ImmunologySir Ganga Ram HospitalNew DelhiIndia
  3. 3.Department of PathologySir Ganga Ram HospitalNew DelhiIndia

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