Assessment of tumor Epstein-Barr Virus status and its impact on outcomes in intermediate and high-risk childhood classic Hodgkin Lymphoma treated at a tertiary cancer center in India. Issue 13 (9th November 2020)

• Record Type: Journal Article
• Authors: Cheriyalinkal Parambil, Badira; Narula, Gaurav; Dhamne, Chetan; Roy Moulik, Nirmalya; Shet, Tanuja; Shridhar, Epari; Gujral, Sumeet; Shah, Sneha; Laskar, Siddhartha; Khanna, Nehal; Banavali, Shripad
• Is Part Of: Leukemia & lymphoma. Volume 61:Issue 13(2020)
• Page Start: 3217
• Page End: 3225
• Publication Date: 2020-11-09
• Subjects: EBV -- Hodgkin Lymphoma -- outcome -- impact -- prognosis; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2020.1800005
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: Indian studies on EBV in childhood classic Hodgkin Lymphoma (cHL) have mainly analyzed the epidemiology of EBV-positive [EBV(+)HL] or negative HL [EBV(–)HL], with limited data on outcomes. We studied a large cohort of children with intermediate and high-Risk cHL for tumor EBV status and its impact on outcomes retrospectively. Of evaluable 189 patients, 84.7% had EBV(+)HL. Positive status was significantly associated with age ≤ 10 years ( p < .001), males ( p = .015), non-Nodular Sclerosis (NS) histology ( p = .004) and inversely with bulky-mediastinal disease ( p < .001). At a median follow-up of 29-months (range1–75), 3-year Event-Free Survival (EFS) for EBV(+)HL and EBV(–)HL was 93.6%(95%CI:89.8%–97.5%), 81.1%(95%CI:67.2%–97.9%), ( p = .048) and Overall Survival (OS) was 94.9%(95%CI:91.6%–98.4%), 84.6%(95%CI:71.5%–100%), ( p = .075) respectively. Three-year EFS was better in males (HR-0.267, 95%CI:0.078–0.916, p = .036) in EBV(+)HL and in patients with serum-albumin > 3g/dL (HR-0.117, 95%CI:0.019–0.705, p = .019) in EBV(–)HL. EBV is associated with most of intermediate and high-risk childhood cHL, occurs in younger male patients with non-NS histology, with reduced incidence of bulky-mediastinal disease and favorable survival in childhood cHL.