Prognostic significance of Epstein-Barr virus (EBV) infection in Hodgkin lymphoma patients

Introduction: The prognostic significance of Epstein-Barr virus (EBV) infection in Hodgkin lymphoma (HL) is still controversial. In this work we sought to examine the prognostic differences between EBV-positive and -negative HL through a series of 131 cases from Tunisia. Methods: The status of EBV was assessed by EBV-encoded RNA (EBER) in situ hybridization. Results were correlated to patients' characteristics and outcome. Results: EBV was detected in the malignant cells in 62 of 131 HL cases (47.3%). EBV-positive HL was associated with extreme age classes (<= 15 and > 45 years; p = 0.0001), male gender (p = 0.008), mixed cellularity histologic subtype (p = 0.03), and inversely with leukocytosis (white blood cells >= 15000/mm(3)) (p = 0.004) and bulky mediastinum (mediastinal-thoracic ratio >= 0.35) (p = 0.0001). On analysis of all patients, no significant difference between survival rates was found between EBV-positive and EBV-negative HL. In contrast, subgroups analysis revealed a negative effect of EBV infection in terms of overall survival in patients with Ann Arbor stages I/II (p = 0.03) and nodular sclerosis HL subgroup (p = 0.01), and in terms of event free survival in patients with mediastinal-thoracic ratio less than 0.35 (p = 0.03). Conclusion: These results suggest that EBV infection affects the survival of particular subgroups of HL, especially those with early-stage of the disease. (C) 2016 Published by Elsevier Ltd on behalf of Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases.