The Prognostic Role of Circulating Epstein-Barr Virus DNA Copy Number in Angioimmunoblastic T-Cell Lymphoma Treated with Dose-Adjusted EPOCH

• Published in: Cancer research and treatment Vol. 51; no. 1; pp. 150 - 157
• Main Authors: Liang, Jin-Hua, Lu, Luo, Zhu, Hua-Yuan, Li, Wang, Fan, Lei, Li, Jian-Yong, Xu, Wei
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Cancer Association 01.01.2019; 대한암학회
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - pharmacology; Cyclophosphamide - administration & dosage; Cyclophosphamide - pharmacology; DNA Copy Number Variations - drug effects; DNA, Viral - drug effects; DNA, Viral - genetics; Doxorubicin - administration & dosage; Doxorubicin - pharmacology; Epstein-Barr Virus Infections - blood; Epstein-Barr Virus Infections - drug therapy; Epstein-Barr Virus Infections - virology; Etoposide - administration & dosage; Etoposide - pharmacology; Female; Herpesvirus 4, Human - drug effects; Herpesvirus 4, Human - genetics; Humans; Lymphocyte Count; Lymphoma, T-Cell - blood; Lymphoma, T-Cell - drug therapy; Lymphoma, T-Cell - virology; Male; Middle Aged; Original; Prednisone - administration & dosage; Prednisone - pharmacology; Prognosis; Retrospective Studies; Survival Analysis; Treatment Outcome; Vincristine - administration & dosage; Vincristine - pharmacology; 의약학; Angioimmunoblastic T-cell lymphoma; Prognosis; Survival; Epstein-Barr virus DNA
• ISSN: 1598-2998; 2005-9256; 2005-9256
• DOI: 10.4143/crt.2017.476

Determine the frequency and prognostic value of circulating Epstein-Barr virus (EBV) DNA copy number in angioimmunoblastic T-cell lymphoma (AITL) patients who were treated with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA-EPOCH) regimens. Sixty newly-diagnosed AITL patients were retrospectively enrolled in the present study. All patients were treated with DA-EPOCH regimen. Twenty-two subjects (36.7%) had a EBV DNA-positive test at diagnosis. EBV DNA‒positive patients were associated with lower lymphocyte-monocyte ratio (p=0.024). Median follow-up was 40 months (range, 14 to 100 months). The overall response rate for all the 60 AITL patents were 71.7% (95% confidence interval [CI], 58.6 to 82.5) with 3-year progressive-free survival (PFS) rate of 30.9%±6.1% and overall survival (OS) rate of 60.1%±6.6%. Not only did PFS estimation differ between the EBV DNA‒positive and EBV DNA‒negative group (hazard ratio [HR], 2.24; 95% CI, 1.15 to 4.35; p=0.006), but also worse OS was observed in the pretreatment EBV DNA‒positive group than in the EBV DNA‒negative group (HR, 2.74; 95% CI, 1.22 to 6.19; p=0.006). EBV DNA test positivity was independent prognostic marker for both PFS (HR, 2.17; 95% CI, 1.17 to 4.00; p=0.014) and OS (HR, 3.24; 95% CI, 1.48 to 7.11; p=0.004) after adjusting International Prognostic Index and prognostic index for AITL score. Reduction in EBV copies was significantly associated with therapy-response. Circulating EBV DNA level was an important prognostic and monitoring marker for AITL patients who treated with DA-EPOCH regimens which cannot improve outcomes for AITL patients.