Age cutoff for Epstein-Barr virus-positive diffuse large B-cell lymphoma--is it necessary?

• Published in: Oncotarget 2015-06, Vol.6 (16), p.13933-13945
• Main Authors: Ok, Chi Young, Ye, Qing, Li, Ling, Manyam, Ganiraju C, Deng, Lijuan, Goswami, Rashmi R, Wang, Xiaoxiao, Montes-Moreno, Santiago, Visco, Carlo, Tzankov, Alexandar, Dybkaer, Karen, Zhang, Li, Abramson, Jeremy, Sohani, Aliyah R, Chiu, April, Orazi, Attilio, Zu, Youli, Bhagat, Govind, Richards, Kristy L, Hsi, Eric D, Choi, William W L, van Krieken, J Han, Huh, Jooryung, Ponzoni, Maurilio, Ferreri, Andrés J M, Zhang, Shanxiang, Parsons, Ben M, Xu, Mina, Møller, Michael B, Winter, Jane N, Piris, Miguel A, Xu-Monette, Zijun Y, Medeiros, L Jeffrey, Young, Ken H
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Animals; Biomarkers, Tumor - metabolism; Epstein-Barr Virus Infections - genetics; Epstein-Barr Virus Infections - metabolism; Epstein-Barr Virus Infections - pathology; Female; Gene Expression Profiling; Humans; Immunohistochemistry; Immunophenotyping; In Situ Hybridization; Lymphoma, Large B-Cell, Diffuse - genetics; Lymphoma, Large B-Cell, Diffuse - metabolism; Lymphoma, Large B-Cell, Diffuse - pathology; Lymphoma, Large B-Cell, Diffuse - virology; Male; Middle Aged; Priority Research Paper; Treatment Outcome; Young Adult
• ISSN: 1949-2553; 1949-2553
• DOI: 10.18632/oncotarget.4324

Epstein-Barr virus-positive diffuse large B-cell lymphoma of the elderly (EBV+ DLBCL-e) is a molecularly distinct variant of DLBCL, characterized by a monoclonal B-cell proliferation that occurs in patients >50 years of age without a history or clinicopathologic evidence of immunodeficiency. However, patients with EBV+ DLBCL younger than 50-years-old also exist in Western countries. We evaluated the clinicopathologic, immunophenotypic and genetic features in Cacausian patients with EBV+ DLBCL who are ≤50 years of age and compared this patient group to patients who are >50 years. In patients who are ≤50 years, less frequent expression of BCL6 and a trend of more frequent expression of CD30 and pSTAT3 were found in patients with EBV+ DLBCL. In patients who are >50 years, common expression of CD30, p50, pSTAT3 and less frequent expression of BCL6 were observed. Older patients also more commonly had a poor performance status (ECOG≥2). Comparing EBV+ DLBCL patients in ≤50 years versus >50 years, both groups had similar clinicopathologic, immunophenotypic and genetic features. Gene expression profiling, microRNA profiling and treatment outcome of the younger patients with EBV+ DLBCL was not distinctive from tumors in older patients. Based on our data, we suggest that the arbitrary age cutoff for EBV+ DLBCL is unnecessary and should be eliminated in the WHO lymphoma classification scheme.