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 KamiyaTomohiro Kinoshita, Shigeo Nakamura

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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

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    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., ... Nakamura, S. (2007). Age-related EBV-associated B-cell lymphoproliferative disorders constitute a distinct clinicopathologic group: A studyof 96 patients. Clinical Cancer Research, 13(17), 5124-5132. https://doi.org/10.1158/1078-0432.CCR-06-2823