Prognostic value of peripheral blood lymphocyte subsets in different infection status of EB virus in lymphoma patients
10.3760/cma.j.cn114452-20240422-00203
- VernacularTitle:外周血淋巴细胞亚群在淋巴瘤不同EB病毒感染状态患者中的预后价值
- Author:
Ziyuan SHEN
1
;
Yujie LI
;
Lingling HU
;
Hui LIU
;
Wei SANG
Author Information
1. 徐州医科大学附属医院血液科,徐州221002
- Keywords:
Lymphoma;
Epstein-Barr virus;
Lymphocyte subsets
- From:
Chinese Journal of Laboratory Medicine
2024;47(7):763-769
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the prognostic value of peripheral blood lymphocyte subsets in lymphoma patients with different infection status of Epstein-Barr virus (EBV).Methods:A retrospective cohort study. A total of 333 lymphoma patients newly diagnosed from November 2012 to August 2023 in the Affiliated Hospital of Xuzhou Medical University were included in the study, including 185 patients with Diffuse Large B-cell Lymphoma (DLBCL), 100 patients with Natural Killer/T-cell Lymphoma (NKTCL), and 48 patients with Hodgkin Lymphoma (HL). Clinical data and laboratory indicators of patients were collected, including lymphocyte subset ratios detected by flow cytometry and EBV-DNA levels measured by real-time quantitative polymerase chain reaction. The survival status of patients was recorded through referring to medical records and telephone follow-up. The Kaplan-Meier method was used to plot survival curves and compare the survival rates among different groups. The Cox proportional hazards model was applied to analyze factors related to overall survival in lymphoma patients.Results:In the NKTCL group, 73.0% (73/100) were positive for EBV-DNA, which was higher than 43.8% (81/185) in the DLBCL group and 35.4% (17/48) in the HL group ( P<0.001). Kaplan-Meier survival curves showed that lower overall survival rates in the DLBCL group with abnormal levels of CD19 +B cells and CD16 +CD56 +NK cells (defined as either high or low referring to the reference intervals), with EBV-DNA negative and abnormal levels of CD19 +B cells, or with EBV-DNA positive and abnormal levels of CD16 +CD56 +NK cells, compared with the normal level group ( P<0.05). Multivariable analysis suggested that the abnormal level of CD19 +B cells was an independent adverse prognostic factor for DLBCL patients ( HR=2.098, 95% CI 1.181-3.727, P=0.011). EBV-DNA positivity ( HR=17.623, 95% CI 2.397-129.565, P=0.048) and Ann Arbor stage (Ⅲ/Ⅳ) ( HR=2.770, 95% CI 1.335-5.750, P=0.006) were adverse prognostic factors for NKTCL patients. Conclusion:There are differences in peripheral blood lymphocyte subsets among lymphoma patients with different EBV infection status, and CD19 +B cell levels may serve as an independent prognostic factor for DLBCL patients.