Significance of circulating Epstein-Barr virus DNA monitoring after remission in patients with extranodal natural killer T cell lymphoma
- Authors
- Cho, Jinhyun; Kim, Seok Jin; Park, Silvia; Yoo, Kwai Han; Ki, Chang-Seok; Ko, Younghyeh; Kim, Won Seog
- Issue Date
- Aug-2018
- Publisher
- SPRINGER
- Keywords
- NK/Tcell lymphoma; EBV; PCR; Biomarker; Relapse
- Citation
- ANNALS OF HEMATOLOGY, v.97, no.8, pp.1427 - 1436
- Journal Title
- ANNALS OF HEMATOLOGY
- Volume
- 97
- Number
- 8
- Start Page
- 1427
- End Page
- 1436
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/3494
- DOI
- 10.1007/s00277-018-3313-x
- ISSN
- 0939-5555
- Abstract
- Circulating Epstein-Barr virus (EBV)-DNA has been established as a useful parameter for diagnosis and predicting prognosis in patients with extranodal natural killer T cell lymphoma (ENKTL); however, the role of monitoring of circulating EBV-DNA after complete remission (CR) is not well established. From January 2008 to August 2016, 328 ENKTL patents were enrolled in 2 lymphoma cohorts. Of 171 patients achieved a CR, 81 had available monitoring data for circulating EBV-DNA with negative post-treatment EBV-DNA. Measurement of circulating EBV-DNA was performed from unfractionated whole blood and calculated according to WHO international standards. Median duration of follow-up was 40.4 months. In 31 of the 81 patients (38.8%), circulating EBV-DNA was detected at least once during follow-up, and 16 of these patients (51.6%) experienced relapse. In contrast, only 7 out of 50 (14.0%) patients with consistently undetectable circulating EBV-DNA experienced relapse (p < 0.001). In multivariate analysis, positive conversion of circulating EBV-DNA was the only independent prognostic factor for occurrence of relapse (HR = 6.552, p < 0.001), progression-free survival (HR = 4.549, p = 0.01), and overall survival (HR = 8.726, p < 0.001). Patients with a higher level of circulating EBV-DNA than 3310 IU/mL (3.52 log(10) IU/mL) showed a strong tendency to relapse (73.3 vs. 31.3%, p = 0.019). In conclusion, positive conversion of circulating EBV-DNA was a valuable indicator of relapse and inferior survival, especially if the level was higher than 3310 IU/mL in ENKTL patients had achieved CR. Close follow-up is necessary for patients developed detectable circulating EBV-DNA after remission.
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