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Impact of tumour Epstein–Barr virus status on clinical outcome in patients with classical Hodgkin lymphoma (cHL): a review of the literature and analysis of a clinical trial cohort of children with cHL

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journal contribution
posted on 2023-11-17, 14:34 authored by Mahdi NohtaniMahdi Nohtani, Katerina Vrzalikova, Maha Ibrahim, Judith E. Powell, Éanna FennellÉanna Fennell, Susan Morgan, Richard Grundy, Keith McCarthy, Sarah Dewberry, Jan Bouchal, Katerina Bouchalova, Pamela Kearns, Paul MurrayPaul Murray

In this study, we have re-evaluated how EBV status influences clinical outcome. To accomplish this, we performed a literature review of all studies that have reported the effect of EBV status on patient outcome and also explored the effect of EBV positivity on outcome in a clinical trial of children with cHL from the UK. Our literature review revealed that almost all studies of older adults/elderly patients have reported an adverse effect of an EBV-positive status on outcome. In younger adults with cHL, EBV-positive status was either associated with a moderate beneficial effect or no effect, and the results in children and adolescents were conflicting. Our own analysis of a series of 166 children with cHL revealed no difference in overall survival between EBV-positive and EBV-negative groups (p = 0.942, log rank test). However, EBV-positive subjects had significantly longer event-free survival (p = 0.0026). Positive latent membrane protein 1 (LMP1) status was associated with a significantly lower risk of treatment failure in a Cox regression model (HR = 0.21, p = 0.005). In models that controlled for age, gender, and stage, EBV status had a similar effect size and statistical significance. This study highlights the age-related impact of EBV status on outcome in cHL patients and suggests different pathogenic effects of EBV at different stages of life.



Cancers 2022, 14, 4297



Other Funding information

The authors acknowledge financial support from Blood Cancer UK and the Cancer Re?search UK Birmingham Centre, University of Birmingham, Birmingham, United Kingdom (KH). The work was also supported in part by a European Regional Development Fund Project (ENOCH:CZ.02.1.01/0.0/0.0/16_019/0000868).

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  • Bernal Institute

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  • (3) Good Health and Well-being

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  • School of Medicine

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