High pretreatment plasma Epstein‐Barr virus (EBV) DNA level is a poor prognostic marker in HIV‐associated, EBV‐negative diffuse large B‐cell lymphoma in Malawi
Abstract Plasma Epstein‐Barr virus (EBV) DNA measurement has established prognostic utility in EBV‐driven lymphomas, where it serves as a circulating tumor DNA marker. The value of plasma EBV measurement may be amplified in sub‐Saharan Africa (SSA), where advanced imaging and molecular technologies...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.2710 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849224359395196928 |
|---|---|
| author | Nathan D. Montgomery Cara Randall Matthew Painschab Ryan Seguin Bongani Kaimila Edwards Kasonkanji Takondwa Zuze Robert Krysiak Marcia K. Sanders Avian Elliott Melissa B. Miller Coxcilly Kampani Fred Chimzimu Maurice Mulenga Blossom Damania Tamiwe Tomoka Yuri Fedoriw Dirk P. Dittmer Satish Gopal |
| author_facet | Nathan D. Montgomery Cara Randall Matthew Painschab Ryan Seguin Bongani Kaimila Edwards Kasonkanji Takondwa Zuze Robert Krysiak Marcia K. Sanders Avian Elliott Melissa B. Miller Coxcilly Kampani Fred Chimzimu Maurice Mulenga Blossom Damania Tamiwe Tomoka Yuri Fedoriw Dirk P. Dittmer Satish Gopal |
| author_sort | Nathan D. Montgomery |
| collection | DOAJ |
| description | Abstract Plasma Epstein‐Barr virus (EBV) DNA measurement has established prognostic utility in EBV‐driven lymphomas, where it serves as a circulating tumor DNA marker. The value of plasma EBV measurement may be amplified in sub‐Saharan Africa (SSA), where advanced imaging and molecular technologies for risk stratification are not typically available. However, its utility in diffuse large B‐cell lymphoma (DLBCL) is less certain, given that only a subset of DLBCLs are EBV‐positive. To explore this possibility, we measured plasma EBV DNA at diagnosis in a cohort of patients with DLBCL in Malawi. High plasma EBV DNA at diagnosis (≥3.0 log10 copies/mL) was associated with decreased overall survival (OS) (P = .048). When stratified by HIV status, the prognostic utility of baseline plasma EBV DNA level was restricted to HIV‐positive patients. Unexpectedly, most HIV‐positive patients with high plasma EBV DNA at diagnosis had EBV‐negative lymphomas, as confirmed by multiple methods. Even in these HIV‐positive patients with EBV‐negative DLBCL, high plasma EBV DNA remained associated with shorter OS (P = .014). These results suggest that EBV reactivation in nontumor cells is a poor prognostic finding even in HIV‐positive patients with convincingly EBV‐negative DLBCL, extending the potential utility of EBV measurement as a valuable and implementable prognostic marker in SSA. |
| format | Article |
| id | doaj-art-51029e26ebfa45efb3c4f63ab7ca7521 |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-51029e26ebfa45efb3c4f63ab7ca75212025-08-25T10:14:04ZengWileyCancer Medicine2045-76342020-01-019255256110.1002/cam4.2710High pretreatment plasma Epstein‐Barr virus (EBV) DNA level is a poor prognostic marker in HIV‐associated, EBV‐negative diffuse large B‐cell lymphoma in MalawiNathan D. Montgomery0Cara Randall1Matthew Painschab2Ryan Seguin3Bongani Kaimila4Edwards Kasonkanji5Takondwa Zuze6Robert Krysiak7Marcia K. Sanders8Avian Elliott9Melissa B. Miller10Coxcilly Kampani11Fred Chimzimu12Maurice Mulenga13Blossom Damania14Tamiwe Tomoka15Yuri Fedoriw16Dirk P. Dittmer17Satish Gopal18Department of Pathology & Laboratory Medicine University of North Carolina Chapel Hill NC USADepartment of Pathology & Laboratory Medicine University of North Carolina Chapel Hill NC USALineberger Comprehensive Cancer Center University of North Carolina Chapel Hill NC USAUNC Project‐Malawi Lilongwe MalawiUNC Project‐Malawi Lilongwe MalawiUNC Project‐Malawi Lilongwe MalawiUNC Project‐Malawi Lilongwe MalawiUNC Project‐Malawi Lilongwe MalawiLineberger Comprehensive Cancer Center University of North Carolina Chapel Hill NC USAUNC Healthcare Chapel Hill NC USADepartment of Pathology & Laboratory Medicine University of North Carolina Chapel Hill NC USAUNC Project‐Malawi Lilongwe MalawiUNC Project‐Malawi Lilongwe MalawiUNC Project‐Malawi Lilongwe MalawiLineberger Comprehensive Cancer Center University of North Carolina Chapel Hill NC USAUNC Project‐Malawi Lilongwe MalawiDepartment of Pathology & Laboratory Medicine University of North Carolina Chapel Hill NC USALineberger Comprehensive Cancer Center University of North Carolina Chapel Hill NC USALineberger Comprehensive Cancer Center University of North Carolina Chapel Hill NC USAAbstract Plasma Epstein‐Barr virus (EBV) DNA measurement has established prognostic utility in EBV‐driven lymphomas, where it serves as a circulating tumor DNA marker. The value of plasma EBV measurement may be amplified in sub‐Saharan Africa (SSA), where advanced imaging and molecular technologies for risk stratification are not typically available. However, its utility in diffuse large B‐cell lymphoma (DLBCL) is less certain, given that only a subset of DLBCLs are EBV‐positive. To explore this possibility, we measured plasma EBV DNA at diagnosis in a cohort of patients with DLBCL in Malawi. High plasma EBV DNA at diagnosis (≥3.0 log10 copies/mL) was associated with decreased overall survival (OS) (P = .048). When stratified by HIV status, the prognostic utility of baseline plasma EBV DNA level was restricted to HIV‐positive patients. Unexpectedly, most HIV‐positive patients with high plasma EBV DNA at diagnosis had EBV‐negative lymphomas, as confirmed by multiple methods. Even in these HIV‐positive patients with EBV‐negative DLBCL, high plasma EBV DNA remained associated with shorter OS (P = .014). These results suggest that EBV reactivation in nontumor cells is a poor prognostic finding even in HIV‐positive patients with convincingly EBV‐negative DLBCL, extending the potential utility of EBV measurement as a valuable and implementable prognostic marker in SSA.https://doi.org/10.1002/cam4.2710diffuse large B‐cell lymphomaEpstein‐Barr virusHIVprognosissub‐Saharan Africa |
| spellingShingle | Nathan D. Montgomery Cara Randall Matthew Painschab Ryan Seguin Bongani Kaimila Edwards Kasonkanji Takondwa Zuze Robert Krysiak Marcia K. Sanders Avian Elliott Melissa B. Miller Coxcilly Kampani Fred Chimzimu Maurice Mulenga Blossom Damania Tamiwe Tomoka Yuri Fedoriw Dirk P. Dittmer Satish Gopal High pretreatment plasma Epstein‐Barr virus (EBV) DNA level is a poor prognostic marker in HIV‐associated, EBV‐negative diffuse large B‐cell lymphoma in Malawi Cancer Medicine diffuse large B‐cell lymphoma Epstein‐Barr virus HIV prognosis sub‐Saharan Africa |
| title | High pretreatment plasma Epstein‐Barr virus (EBV) DNA level is a poor prognostic marker in HIV‐associated, EBV‐negative diffuse large B‐cell lymphoma in Malawi |
| title_full | High pretreatment plasma Epstein‐Barr virus (EBV) DNA level is a poor prognostic marker in HIV‐associated, EBV‐negative diffuse large B‐cell lymphoma in Malawi |
| title_fullStr | High pretreatment plasma Epstein‐Barr virus (EBV) DNA level is a poor prognostic marker in HIV‐associated, EBV‐negative diffuse large B‐cell lymphoma in Malawi |
| title_full_unstemmed | High pretreatment plasma Epstein‐Barr virus (EBV) DNA level is a poor prognostic marker in HIV‐associated, EBV‐negative diffuse large B‐cell lymphoma in Malawi |
| title_short | High pretreatment plasma Epstein‐Barr virus (EBV) DNA level is a poor prognostic marker in HIV‐associated, EBV‐negative diffuse large B‐cell lymphoma in Malawi |
| title_sort | high pretreatment plasma epstein barr virus ebv dna level is a poor prognostic marker in hiv associated ebv negative diffuse large b cell lymphoma in malawi |
| topic | diffuse large B‐cell lymphoma Epstein‐Barr virus HIV prognosis sub‐Saharan Africa |
| url | https://doi.org/10.1002/cam4.2710 |
| work_keys_str_mv | AT nathandmontgomery highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT cararandall highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT matthewpainschab highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT ryanseguin highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT bonganikaimila highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT edwardskasonkanji highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT takondwazuze highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT robertkrysiak highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT marciaksanders highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT avianelliott highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT melissabmiller highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT coxcillykampani highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT fredchimzimu highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT mauricemulenga highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT blossomdamania highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT tamiwetomoka highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT yurifedoriw highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT dirkpdittmer highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi AT satishgopal highpretreatmentplasmaepsteinbarrvirusebvdnalevelisapoorprognosticmarkerinhivassociatedebvnegativediffuselargebcelllymphomainmalawi |