Prospective measurement of Epstein-Barr virus DNA in plasma and peripheral blood mononuclear cells of extranodal NK/T-cell lymphoma, nasal type
Cette étude (32 cas) évalue la valeur pronostique du niveau d'ADN du virus Epstein-Barr dans les cellules mononucléées du sang périphérique et dans le plasma de patients atteints d'un lymphome T/NK de type nasal
Epstein-Barr virus (EBV)-DNA was prospectively analyzed in plasma and mononuclear cells (MNCs) from peripheral blood in patients with extranodal NK/T-cell lymphoma, nasal type (NKTCL), to evaluate the clinical significance for diagnosis, monitoring the tumor burden, and prognostication. Thirty-three patients were enrolled, and 32 were evaluable. Pretreatment plasma and MNC EBV-DNA was detectable in 14 (range: 50-71,000 copies/ml) and 6 patients (range: 20-780 copies/µgDNA), respectively, and both were well correlated (r = 0.8741, P < 0.0001). Detectable plasma EBV-DNA was associated with higher clinical stage (P = 0.02), presence of B-symptoms (P = 0.02), worse performance status (P = 0.02), and higher serum soluble IL-2 receptor level (P < 0.0001). Twenty-two patients attained complete response. Plasma EBV-DNA level was significantly higher in non-responders than in responders (mean: 16,472 vs. 2,645 copies/ml, P = 0.02). Multivariate analysis showed clinical stage (hazard ratio: 9.0, 95% confidence interval: 1.8-45.0) and pretreatment plasma EBV-DNA (hazard ratio: 10.6, 95% confidence interval: 1.3-87.0) were significant prognostic factors. 3-year overall survival of plasma EBV-DNA positive and negative patients was 42.9% and 94.4%, respectively (P = 0.0009). Plasma was a preferable sample for this purpose in NKTCL, and EBV-DNA level was a good indicator for response and overall survival.
Blood , résumé, 2011