J Cancer 2020; 11(17):4980-4988. doi:10.7150/jca.37484

Research Paper

High viral loads of circulating Epstein-Barr virus DNA copy number in peripheral blood is associated with inferior prognosis in patients with mantle cell lymphoma

Xiao-Hui Zhou1,2,3*, Jin-Hua Liang1,2,3*, Li Wang1,2,3, Hua-Yuan Zhu1,2,3, Jia-Zhu Wu1,2,3, Yi Xia1,2,3, Yue Li1,2,3, Shu-Chao Qin1,2,3, Lei Fan1,2,3, Jian-Yong Li1,2,3, Wei Xu1,2,3✉

1. Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China.
2. Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, China.
3. Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, China.
*These authors contributed equally to this work.

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Citation:
Zhou XH, Liang JH, Wang L, Zhu HY, Wu JZ, Xia Y, Li Y, Qin SC, Fan L, Li JY, Xu W. High viral loads of circulating Epstein-Barr virus DNA copy number in peripheral blood is associated with inferior prognosis in patients with mantle cell lymphoma. J Cancer 2020; 11(17):4980-4988. doi:10.7150/jca.37484. Available from http://www.jcancer.org/v11p4980.htm

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Abstract

Mantle cell lymphoma (MCL) is a distinct subtype of B cell non-Hodgkin lymphoma. No research has yet documented to investigate the prognostic implications of Epstein-Barr virus (EBV) infection in MCL. The objective of this study was to determine whether EBV DNA load may influence the heterogeneity in the course of the disease in MCL patients. Eighty-eight MCL patients were retrospectively enrolled in the study. EBV DNA load was detected by real-time quantitative PCR for quantification. The univariate and multivariate Cox proportional hazards models were established for the estimation of prognostic factors. Twenty-seven patients were detected positive for EBV DNA and the median virus titer was 1.72×104 copies/mL (range, 8.20×102 to 4.14×105 copies/mL). With a median follow-up of 39 months (range, 9 to 120 months), patients in EBV DNA-positive group displayed unfavorable progression-free survival (PFS) (P=0.012) and overall survival (OS) (P=0.004) than patients in EBV DNA-negative group. Multivariate Cox regression analysis revealed that EBV DNA-positivity was an independent risk factor for both PFS (HR, 2.04; 95% CI, 1.07 to 3.92; P=0.031) and OS (HR, 2.68; 95% CI, 1.20 to 6.00; P=0.016). Reduction in EBV copies was significantly associated with therapy-response.

Circulating EBV DNA load in whole blood proved to be a significant predictor of prognosis in patients with MCL, which needs further validation in large-scale clinical studies.

Keywords: Mantle cell lymphoma, Circulating Epstein-Barr virus DNA load, Overall survival, Progression free survival