Age-related EBV-associated B-cell lymphoproliferative disorders constitute a distinct clinicopathologic group

A studyof 96 patients

Takashi Oyama, Kazuhito Yamamoto, Naoko Asano, Aya Oshiro, Ritsuro Suzuki, Yoshitoyo Kagami, Yasuo Morishima, Kengo Takeuchi, Toshiyuki Izumo, Shigeo Mori, Koichi Ohshima, Junji Suzumiya, Naoya Nakamura, Masafumi Abe, Koichi Ichimura, Yumiko Sato, Tadashi Yoshino, Tomoki Naoe, Yoshie Shimoyama, Yoshikazu Kamiya & 2 others Tomohiro Kinoshita, Shigeo Nakamura

Research output: Contribution to journalArticle

306 Citations (Scopus)

Abstract

Purpose: We have recently reported EBV+ B-cell lymphoproliferative disorders (LPD) occurring predominantly in elderly patients, which shared features of EBV+ B-cell neoplasms arising in the immunologically deteriorated patients despite no predisposing immunodeficiency and were named as senile or age-related EBV+ B-cell LPDs. To further characterize this disease, age-related EBV+ B-cell LPDs were compared with EBV-negative diffuse large B-cell lymphomas (DLBCL). Experimental Design: Among 1,792 large B-cell LPD cases, 96 EBV+ cases with available clinical data set were enrolled for the present study. For the control group, 107 patients aged over 40 yearswith EBV-negative DLBCL were selected. We compared clinicopathologic data between two groups and determined prognostic factors by univariate and multivariate analysis. Results: Patients with age-related EBV+ B-cell LPDs showed a higher age distribution and aggressive clinical features or parameters than EBV-negative DLBCLs: 44% with performance status >1, 58% with serum lactate dehydrogenase level higher than normal, 49% with B symptoms, and higher involvement of skin and lung. Overall survival was thus significantly inferior in age-related EBV+ group than in DLBCLs. Univariate and multivariate analyses further identified two factors, B symptoms and age older than 70 years, independently predictive for survival. A prognostic model using these two variables well defined three risk groups: low risk (no adverse factors), intermediate risk (one factor), and high risk (two factors). Conclusions: These findings suggest that age-related EBV+ B-cell LPDs constitute a distinct group, and innovative therapeutic strategies such as EBV-targeted T-cell therapy should be developed for this uncommon disease.

Original languageEnglish
Pages (from-to)5124-5132
Number of pages9
JournalClinical Cancer Research
Volume13
Issue number17
DOIs
Publication statusPublished - Sep 1 2007

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Lymphoproliferative Disorders
Human Herpesvirus 4
B-Lymphocytes
Lymphoma, Large B-Cell, Diffuse
Multivariate Analysis
Survival
Age Distribution
Cell- and Tissue-Based Therapy
L-Lactate Dehydrogenase
Statistical Factor Analysis
Research Design

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Age-related EBV-associated B-cell lymphoproliferative disorders constitute a distinct clinicopathologic group : A studyof 96 patients. / Oyama, Takashi; Yamamoto, Kazuhito; Asano, Naoko; Oshiro, Aya; Suzuki, Ritsuro; Kagami, Yoshitoyo; Morishima, Yasuo; Takeuchi, Kengo; Izumo, Toshiyuki; Mori, Shigeo; Ohshima, Koichi; Suzumiya, Junji; Nakamura, Naoya; Abe, Masafumi; Ichimura, Koichi; Sato, Yumiko; Yoshino, Tadashi; Naoe, Tomoki; Shimoyama, Yoshie; Kamiya, Yoshikazu; Kinoshita, Tomohiro; Nakamura, Shigeo.

In: Clinical Cancer Research, Vol. 13, No. 17, 01.09.2007, p. 5124-5132.

Research output: Contribution to journalArticle

Oyama, T, Yamamoto, K, Asano, N, Oshiro, A, Suzuki, R, Kagami, Y, Morishima, Y, Takeuchi, K, Izumo, T, Mori, S, Ohshima, K, Suzumiya, J, Nakamura, N, Abe, M, Ichimura, K, Sato, Y, Yoshino, T, Naoe, T, Shimoyama, Y, Kamiya, Y, Kinoshita, T & Nakamura, S 2007, 'Age-related EBV-associated B-cell lymphoproliferative disorders constitute a distinct clinicopathologic group: A studyof 96 patients', Clinical Cancer Research, vol. 13, no. 17, pp. 5124-5132. https://doi.org/10.1158/1078-0432.CCR-06-2823
Oyama, Takashi ; Yamamoto, Kazuhito ; Asano, Naoko ; Oshiro, Aya ; Suzuki, Ritsuro ; Kagami, Yoshitoyo ; Morishima, Yasuo ; Takeuchi, Kengo ; Izumo, Toshiyuki ; Mori, Shigeo ; Ohshima, Koichi ; Suzumiya, Junji ; Nakamura, Naoya ; Abe, Masafumi ; Ichimura, Koichi ; Sato, Yumiko ; Yoshino, Tadashi ; Naoe, Tomoki ; Shimoyama, Yoshie ; Kamiya, Yoshikazu ; Kinoshita, Tomohiro ; Nakamura, Shigeo. / Age-related EBV-associated B-cell lymphoproliferative disorders constitute a distinct clinicopathologic group : A studyof 96 patients. In: Clinical Cancer Research. 2007 ; Vol. 13, No. 17. pp. 5124-5132.
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T1 - Age-related EBV-associated B-cell lymphoproliferative disorders constitute a distinct clinicopathologic group

T2 - A studyof 96 patients

AU - Oyama, Takashi

AU - Yamamoto, Kazuhito

AU - Asano, Naoko

AU - Oshiro, Aya

AU - Suzuki, Ritsuro

AU - Kagami, Yoshitoyo

AU - Morishima, Yasuo

AU - Takeuchi, Kengo

AU - Izumo, Toshiyuki

AU - Mori, Shigeo

AU - Ohshima, Koichi

AU - Suzumiya, Junji

AU - Nakamura, Naoya

AU - Abe, Masafumi

AU - Ichimura, Koichi

AU - Sato, Yumiko

AU - Yoshino, Tadashi

AU - Naoe, Tomoki

AU - Shimoyama, Yoshie

AU - Kamiya, Yoshikazu

AU - Kinoshita, Tomohiro

AU - Nakamura, Shigeo

PY - 2007/9/1

Y1 - 2007/9/1

N2 - Purpose: We have recently reported EBV+ B-cell lymphoproliferative disorders (LPD) occurring predominantly in elderly patients, which shared features of EBV+ B-cell neoplasms arising in the immunologically deteriorated patients despite no predisposing immunodeficiency and were named as senile or age-related EBV+ B-cell LPDs. To further characterize this disease, age-related EBV+ B-cell LPDs were compared with EBV-negative diffuse large B-cell lymphomas (DLBCL). Experimental Design: Among 1,792 large B-cell LPD cases, 96 EBV+ cases with available clinical data set were enrolled for the present study. For the control group, 107 patients aged over 40 yearswith EBV-negative DLBCL were selected. We compared clinicopathologic data between two groups and determined prognostic factors by univariate and multivariate analysis. Results: Patients with age-related EBV+ B-cell LPDs showed a higher age distribution and aggressive clinical features or parameters than EBV-negative DLBCLs: 44% with performance status >1, 58% with serum lactate dehydrogenase level higher than normal, 49% with B symptoms, and higher involvement of skin and lung. Overall survival was thus significantly inferior in age-related EBV+ group than in DLBCLs. Univariate and multivariate analyses further identified two factors, B symptoms and age older than 70 years, independently predictive for survival. A prognostic model using these two variables well defined three risk groups: low risk (no adverse factors), intermediate risk (one factor), and high risk (two factors). Conclusions: These findings suggest that age-related EBV+ B-cell LPDs constitute a distinct group, and innovative therapeutic strategies such as EBV-targeted T-cell therapy should be developed for this uncommon disease.

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