Significance of whole-blood EBV DNA status in T/NK-cell lymphoma-associated hemophagocytic lymphohistiocytosis: a single-center retrospective analysis.

IF 3.4 3区医学 Q2 HEMATOLOGY

Therapeutic Advances in Hematology Pub Date : 2025-02-17 eCollection Date: 2025-01-01 DOI:10.1177/20406207251319604

Mengqi Xiong, Li Li, Lulu Wang, Lixia Zhu, Rongrong Chen, Jingsong He, Xiujin Ye

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引用次数: 0

Abstract

Background: Hemophagocytic lymphohistiocytosis (HLH) is a severe hyperinflammatory condition often triggered by malignancies, especially T/NK-cell lymphoma-associated HLH (T/NK-LAHLH). Epstein-Barr virus (EBV) infection is strongly linked to T/NK-LAHLH and worsens prognosis. However, the prognostic value of whole-blood EBV DNA levels in T/NK-LAHLH remains unclear, necessitating further investigation to improve risk assessment and treatment strategies.

Objective: To investigate the clinical characteristics and prognostic significance of whole-blood EBV DNA status in patients with T/NK-LAHLH.

Design: A single-center, retrospective study was conducted, including 85 patients diagnosed with T/NK-LAHLH between January 2017 and August 2022. Patients were categorized based on EBV DNA status, and clinical outcomes were compared.

Methods: EBV DNA levels were quantified using polymerase chain reaction (PCR) assays. Kaplan-Meier survival and Cox regression models to assess overall survival (OS) and identify independent prognostic factors.

Results: A total of 85 T/NK-LAHLH patients were included, with a median age of 52 years (range: 18-81 years) and 60% male. The OS rates at 1, 3, 6, and 12 months were 66.6%, 49.8%, 33.8%, and 28.4%, respectively. Among these patients, 67 (78.8%) were EBV DNA-positive, while 18 (21.2%) were EBV DNA negative. EBV DNA-positive patients exhibited significantly lower platelet and globulin levels, higher IL-10 levels, and prolonged activated partial thromboplastin time compared to EBV DNA-negative patients (p < 0.05). The 6-month OS rate was significantly lower in EBV DNA-positive patients compared to EBV DNA-negative patients (22.5% vs 75.1%, p < 0.001). Multivariate analysis identified EBV DNA positivity as an independent risk factor for shorter 6-month OS (hazard ratio (HR): 4.715; 95% CI: 1.662-13.377; p = 0.004). Among the four patients who underwent allogeneic hematopoietic stem cell transplantation, all achieved complete remission and remained alive at the last follow-up.

Conclusion: Whole-blood EBV DNA positivity is a significant prognostic factor for poor outcomes in T/NK-LAHLH patients. These findings highlight the need for incorporating EBV DNA monitoring into clinical management and further research to refine therapeutic strategies.

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全血EBV DNA在T/ nk细胞淋巴瘤相关的噬血细胞淋巴组织细胞增多症中的意义：一项单中心回顾性分析

背景：噬血细胞性淋巴组织细胞增多症（HLH）是一种严重的高炎症性疾病，通常由恶性肿瘤引起，尤其是T/ nk细胞淋巴瘤相关的HLH （T/NK-LAHLH）。eb病毒（EBV）感染与T/NK-LAHLH密切相关，并使预后恶化。然而，全血EBV DNA水平对T/NK-LAHLH的预后价值尚不清楚，需要进一步研究以改进风险评估和治疗策略。目的：探讨T/NK-LAHLH患者全血EBV DNA水平的临床特点及预后意义。设计：采用单中心回顾性研究，纳入85例2017年1月至2022年8月诊断为T/NK-LAHLH的患者。根据EBV DNA状态对患者进行分类，并比较临床结果。方法：采用聚合酶链反应（PCR）法测定EBV DNA水平。Kaplan-Meier生存和Cox回归模型评估总生存（OS）和确定独立预后因素。结果：共纳入T/NK-LAHLH患者85例，中位年龄52岁（范围18-81岁），男性占60%。1、3、6、12个月的总生存率分别为66.6%、49.8%、33.8%、28.4%。其中67例（78.8%）EBV DNA阳性，18例（21.2%）EBV DNA阴性。与EBV dna阴性患者相比，EBV dna阳性患者血小板和球蛋白水平明显降低，IL-10水平升高，活化的部分凝血活素时间延长（p < 0.05）。EBV dna阳性患者的6个月OS率明显低于EBV dna阴性患者（22.5% vs 75.1%, p < 0.001）。多因素分析发现EBV DNA阳性是短6个月OS的独立危险因素(危险比（HR）： 4.715；95% ci: 1.662-13.377；P = 0.004)。在接受同种异体造血干细胞移植的4例患者中，所有患者在最后一次随访时均获得完全缓解并存活。结论：EBV DNA全血阳性是T/NK-LAHLH患者预后不良的重要因素。这些发现强调了将EBV DNA监测纳入临床管理和进一步研究以完善治疗策略的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Advances in Hematology HEMATOLOGY-

CiteScore

4.30

自引率

0.00%

发文量

审稿时长

7 weeks

期刊介绍： Therapeutic Advances in Hematology delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of hematology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in hematology, providing a forum in print and online for publishing the highest quality articles in this area.