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Reappraisal of EBV in diffuse large B-cell lymphoma (DLBCL): comparative analysis between EBV-positive and -negative DLBCL with EBV-positive bystander cells.

Reappraisal of EBV in diffuse large B-cell lymphoma (DLBCL): comparative analysis between EBV-positive and -negative DLBCL with EBV-positive bystander cells.
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Ohashi A, Kato S, Okamoto A, Inaguma Y, Satou A, Tsuzuki T, Emi N, Okamoto M, Nakamura S,


Ohashi A, Kato S, Okamoto A, Inaguma Y, Satou A, Tsuzuki T, Emi N, Okamoto M, Nakamura S, (click to view)

Ohashi A, Kato S, Okamoto A, Inaguma Y, Satou A, Tsuzuki T, Emi N, Okamoto M, Nakamura S,

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Histopathology 2017 02 23() doi 10.1111/his.13197
Abstract
AIMS
Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS) is defined as monoclonal EBV(+) B-cell proliferation affecting patients without any known immunosuppression. Non-neoplastic EBV(+) cells proliferating in or adjacent to EBV(-) DLBCL were reported recently, but their clinical significance is unclear. Thus, we investigated the prognostic impact of EBV(+) cells in DLBCL.

METHODS AND RESULTS
We compared the clinico-pathological characteristics of 30 EBV(+) DLBCL patients and 29 and 604 EBV(-) DLBCL patients with and without EBV(+) bystander cells (median age of onset 71, 67, and 62 years, respectively). Both of EBV(+) DLBCL patients and EBV(-) DLBCL patients with EBV(+) bystander cells tended to have high and high-intermediate International Prognostic Index scores (60% and 59%, respectively), compared with only 46% of EBV(-) DLBCL patients without EBV(+) bystander cells. EBV(-) DLBCL patients with EBV(+) bystander cells exhibited a significantly higher incidence of lung involvement than those without EBV(+) bystander cells (10% vs. 2%, P<0.05). Furthermore, EBV(+) DLBCL patients and EBV(-) DLBCL patients with EBV(+) bystander cells had poorer prognosis than patients without any detectable EBV(+) cells (median overall survival [OS] 100 and 40 months vs. not reached, P<0.01). Notably, cases of EBV(+) DLBCL and EBV(-) DLBCL with EBV(+) bystander cells treated with rituximab demonstrated overlapping survival curves (OS, P=0.77, progression-free survival, P=1.0). CONCLUSIONS
EBV(-) DLBCL with bystander EBV(+) cells has similar clinical characteristics as EBV(+) DLBCL. DLBCL with EBV(+) bystander cells may be related to both age and microenvironment-related immunological deterioration. This article is protected by copyright. All rights reserved.

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