Clinical impact of cell-free serum Epstein–Barr virus status in patients with newly diagnosed malignant lymphoma
	    		
		   		
		   			
		   		
	    	
    	- Author:
	        		
		        		
		        		
			        		Dong Won BAEK
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Jung Min LEE
			        		
			        		;
		        		
		        		
		        		
			        		Juhyung KIM
			        		
			        		;
		        		
		        		
		        		
			        		Hee Jeong CHO
			        		
			        		;
		        		
		        		
		        		
			        		Sang Kyun SOHN
			        		
			        		;
		        		
		        		
		        		
			        		Ji Yeon HAM
			        		
			        		;
		        		
		        		
		        		
			        		Soon Hee CHANG
			        		
			        		;
		        		
		        		
		        		
			        		Joon Ho MOON
			        		
			        		;
		        		
		        		
		        		
			        		Deok-Hwan YANG
			        		
			        		
		        		
		        		
		        		
			        		
			        		Author Information
			        		
 - Publication Type:ORIGINAL ARTICLE
 - From:Blood Research 2021;56(2):65-71
 - CountryRepublic of Korea
 - Language:English
 - 
		        	Abstract:
			       	
			       		
				        
				        	Background:We analyzed cell-free serum Epstein‒Barr virus (EBV) DNA to identify its prognostic role in patients with newly diagnosed lymphoma. 
				        	
Methods:We retrospectively reviewed patients diagnosed with lymphoma between January 2014 and July 2020. Patients were enrolled according to the following criteria: i) pathologically confirmed lymphomas according to the World Health Organization criteria, ii) age over 18 years, iii) serum EBV DNA measurement using polymerase chain reaction prior to first-line therapy, and iv) receipt of curative standard chemotherapy. In total, 263 patients met these criteria and were included in this study.
Results:Serum EBV DNA was detected in 79 patients (30.0%). Patients with positive serum EBV tended to be older (P =0.090), and the proportion of T-cell lineage lymphomas was higher than that of B-cell lymphomas (P =0.003). EBV positivity was significantly associated with more advanced disease based on the Ann Arbor staging system (P =0.008) and the International Prognostic Index (P =0.009). EBV positivity was also associated with higher disease relapse (P =0.038) and death rates (P =0.005). EBV-positive lymphomas further showed inferior long-term survival outcomes in terms of progression-free survival (PFS) (P =0.053) and overall survival (OS) (P =0.014). In the subgroup analyses, serum EBV positivity was a significant prognostic factor for patients with B-cell lineage lymphomas in terms of PFS (P =0.003) and OS (P =0.033).
Conclusion:We demonstrated that cell-free serum EBV DNA status at the time of diagnosis has potential as a prognostic biomarker for patients with newly diagnosed malignant lymphomas. 
            