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Epstein‐Barr virus in monitoring the response to therapy of acquired immunodeficiency syndrome–related primary central nervous system lymphoma
Author(s) -
Antinori Andrea,
Cingolani Antonella,
De Luca Andrea,
Gaidano Gianluca,
Ammassari Adriana,
Larocca Luigi M.,
Ortona Luigi
Publication year - 1999
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/1531-8249(199902)45:2<259::aid-ana19>3.0.co;2-g
Subject(s) - primary central nervous system lymphoma , lymphoma , virus , chemotherapy , epstein–barr virus , polymerase chain reaction , cerebrospinal fluid , immunology , herpesviridae , virology , immunodeficiency , viral disease , medicine , pathology , biology , immune system , gene , biochemistry
To evaluate the value of Epstein‐Barr virus DNA (EBV‐DNA) assay in cerebrospinal fluid (CSF) for monitoring the response to treatment in acquired immunodeficiency syndrome–related primary central nervous system lymphoma (AIDS‐PCNSL), 9 human immunodeficiency virus–infected patients with biopsy‐proven AIDS‐PCNSL who underwent multimodal therapy were investigated for EBV‐DNA detection in CSF by semiquantitative nested polymerase chain reaction (PCR). Tumoral tissue expression of bcl‐6 oncogene protein and of EBV‐encoded latent membrane protein (LMP‐1) was also investigated. The 2 patients who had a response to chemotherapy showed a reduction of mean EBV‐DNA concentration values after chemotherapy and displayed a large noncleaved morphology and a BCL‐6 + /LMP‐1 − phenotype. Conversely, the 4 patients with progressive disease after chemotherapy showed increasing mean values of EBV‐DNA and displayed an immunoblastic morphology and a BCL‐6 − /LMP‐1 + phenotype. No significant changes were observed for patients with stable disease. EBV‐DNA burden reduction was significantly associated with prolonged survival. These results suggest that EBV‐DNA monitoring might be helpful in predicting response to chemotherapy and in segregating distinct biological and prognostic categories of AIDS‐PCNSL. Ann Neurol 1999;45:259–261