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EBV‐positive diffuse large B‐cell lymphoma of the elderly: A case series from Peru
Author(s) -
Beltran Brady E.,
Castillo Jorge J.,
Morales Domingo,
de Mendoza Fernando Hurtado,
Quis Pilar,
Miranda Roberto N.,
Gallo Aly,
LopezIlasaca Marco,
Butera James N.,
Sotomayor Eduardo M.
Publication year - 2011
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.22078
Subject(s) - rituximab , diffuse large b cell lymphoma , medicine , international prognostic index , univariate analysis , lymphoma , stage (stratigraphy) , chop , oncology , b symptoms , large cell lymphoma , multivariate analysis , biology , paleontology
EBV‐positive diffuse large B‐cell lymphoma (DLBCL) of the elderly is an entity recently included in the WHO classification of lymphoid tumors. We have reviewed our experience and clinical outcomes of this distinct subtype of DLBCL. Between 2002 and 2009, cases of DLBCL were identified from medical records of the Hospital Nacional Edgardo Rebagliati Martins in Lima, Peru, and underwent pathological evaluation including immunohistochemistry for CD20, CD10, bcl‐6, MUM1/IRF4, and EBV‐encoded RNA in situ hybridization. Clinical data were gathered, tabulated, and reported descriptively. Survival analyses were performed using Kaplan‐Meier estimates. Out of 199 cases of DLBCL, 28 cases of EBV‐positive DLBCL of the elderly were identified. The median age was 75 years with male predominance (1.5:1). B‐symptoms were present in 43%, advanced stage in 50% and International Prognostic Index (IPI) score > 2 in 57% of patients; 68% of patients had a nongerminal center (NGC) phenotype. The complete response rates to R‐CHOP and CHOP were 63% and 33%, respectively. The median overall survival (OS) for the group was 5 months. In the univariate analysis, age ≥70 years, lymphocyte count <1.0 × 10 9 /L, and advanced clinical stage were associated with worse OS in patients treated with chemotherapy with and without rituximab. EBV‐positive DLBCL of the elderly is a clinically aggressive entity with a short OS and typically presents with advanced stage, high IPI score, and a NGC phenotype. Further studies are needed to investigate if rituximab‐containing regimens are associated with better response and OS rates in EBV‐positive DLBCL of the elderly. Am. J. Hematol. 86:663–667, 2011. © 2011 Wiley‐Liss, Inc.