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Prognostic significance of CD 20 expression and E pstein‐ B arr virus ( EBV ) association in classical H odgkin lymphoma in J apan: A clinicopathologic study
Author(s) -
Elsayed Ahmed Ali,
Asano Naoko,
Ohshima Koichi,
Izutsu Koji,
Kinoshita Tomohiro,
Nakamura Shigeo
Publication year - 2014
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/pin.12175
Subject(s) - medicine , b symptoms , lymphoma , gastroenterology , lactate dehydrogenase , epstein–barr virus , risk factor , epstein–barr virus infection , virus , cd20 , pathology , immunology , biology , enzyme , biochemistry
To investigate the clinicopathological significance of CD 20 expression and E pstein‐ B arr virus ( EBV ) association in H odgkin and R eed– S terberg cells of classical H odgkin lymphoma ( CHL ), CD 20 expression and EBV positivity (by EBER in situ hybridization) were investigated in 389 CHL patients in J apan. They included 74 CD 20‐positive cases (19%) and 315 CD 20‐negative cases (81%). CD 20‐positive cases showed significantly older age at onset ( P = 0.018) and higher association with EBV ( P = 0.002). Multivariate analysis identified EBV ‐positivity (but not CD 20‐positivity), presence of B symptoms, thrombocytopenia, elevated serum lactate dehydrogenase and performance status >1 as poor prognostic factors for overall survival ( OS ). We constructed a new prognostic model with these five factors classifying patients into three groups: low risk, 0–1 adverse factor; intermediate risk, 2–3 factors; high risk, 4–5 factors. This prognostic model could stratify the prognosis of CHL patients ( P < 0.0001). For 144 patients (58%) classified into the low‐risk group, the 5‐year OS was 91%. For 92 patients (37%) in the intermediate group, the 5‐year OS was 66%; for 11 patients (5%) in the high‐risk group, the 5‐year OS was 36%. In conclusion, EBV is identified as an independent poor prognostic factor for CHL patients. Therefore, examination of EBV association in CHL is recommended as routine pathologic practice especially in countries where EBV infection prevails.