Plasma Epstein-Barr virus (EBV) DNA as a biomarker for EBV-associated Hodgkin lymphoma
- 53 Downloads
To assess plasma Epstein-Barr virus (EBV) DNA as a biomarker of tumour burden at diagnosis and during therapy in children with Hodgkin lymphoma.
Case-control study, with prospective follow-up of the Hodgkin lymphoma cohort (2007-2012).
Pediatric Hematology Oncology unit of a tertiary care hospital in Delhi.
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).
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: 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.
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.
KeywordsFollow-up Immuno-histochemistry Outcome
Unable to display preview. Download preview PDF.
- 8.Naresh KN, Johnson J, Srinivas V, Soman CS, Saikia T, Advani SH, et al. Epstein-Barr virus association in classical Hodgkin’s disease provides survival advantage to patients and correlates with higher expression of proliferation markers in Reed-Sternberg cells. Ann Oncol. 2000;(11):91–6.CrossRefPubMedGoogle Scholar
- 16.Jarett RF, Stark GL, White J, Angus B, Alexander FE, Krajewski AS, et al. Scotland and Newcastle Epidemiology of Hodgkin Disease Study Group. Impact of tumor Epstein-Barr virus status on presenting features and outcome in age-defined subgroups of patients with classic Hodgkin lymphoma: a population-based study. Blood. 2005;(106):2444–51.CrossRefGoogle Scholar