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Response and survival benefit with chemoimmunotherapy in Epstein‐Barr virus‐positive diffuse large B‐cell lymphoma
Authors:Brady E Beltran  Pilar Quiñones  Domingo Morales  Jose M Malaga  Julio C Chavez  Eduardo M Sotomayor  Jorge J Castillo
Institution:1. Department of Oncology and Radiotherapy, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru;2. Department of Pathology, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru;3. Department of Hematology, Hospital Alberto Seguin, Arequipa, Peru;4. Division of Hematology and Oncology, Moffitt Cancer Center, Tampa, FL, USA;5. Division of Hematology/Oncology, George Washington University Cancer Center, Washington, DC, USA;6. Division of Hematologic Malignancies, Dana‐Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
Abstract:Epstein‐Barr virus (EBV)‐positive diffuse large B‐cell lymphoma (DLBCL) is a haematologic malignancy with poor prognosis when treated with chemotherapy. We evaluated response and survival benefits of chemoimmunotherapy in EBV‐positive DLBCL patients. A total of 117 DLBCL patients were included in our retrospective analysis; 33 were EBV‐positive (17 treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone R‐CHOP] and 16 with CHOP), and 84 were EBV‐negative (all treated with R‐CHOP). The outcomes of interest were complete response (CR) and overall survival (OS) in EBV‐positive DLBCL patients (R‐CHOP versus CHOP) and in DLBCL patients treated with R‐CHOP (EBV‐positive vs EBV‐negative). There were no differences in the clinical characteristics between EBV‐positive and EBV‐negative DLBCL patients. Among EBV‐positive DLBCL patients, R‐CHOP was associated with higher odds of CR (OR 3.14, 95% CI 0.75‐13.2; P = .10) and better OS (hazard ratio 0.30, 95% confidence interval CI] 0.09‐0.94; P = .04). There were no differences in CR rate (OR 0.52, 95% CI 0.18‐1.56; P = .25) or OS (hazard ratio 0.93, 95% CI 0.32‐2.67; P = .89) between EBV‐positive and EBV‐negative DLBCL patients treated with R‐CHOP. Based on our study, the addition of rituximab to CHOP is associated with improved response and survival in EBV‐positive DLBCL patients. Epstein‐Barr virus status does not seem to affect response or survival in DLBCL patients treated with R‐CHOP.
Keywords:diffuse large B‐cell lymphoma  DLBCL  EBV  Epstein‐Barr virus  rituximab
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