Journal Article

EBV-positive diffuse large B-cell lymphoma of the elderly is an aggressive post-germinal center B-cell neoplasm characterized by prominent nuclear factor-kB activation

Adrados, Magdalena, Suarez-Gauthier, Ana, Montes-Moreno, Santiago, Pajares, Raquel, Franco, Renato, Young, Ken H, Mollejo, Manuela, de Villambrosía, Sonia Gonzalez, García, Juan F, Diaz-Perez, Julio A, Castillo, Maria E, Mazorra, Francisco, Lopez, Mar, Camacho, Francisca I, Ruiz-Marcellán, Carmen, Ortiz, Nazario, Ortiz-Hidalgo, Carlos, Odqvist, Lina, Lopez, Ana Batlle, Piris, Miguel A

2012

Overview

Here, we report a retrospective series of 47 EBV-positive diffuse large B-cell lymphoma associated with advanced age. Histopathology allowed to the identification of different histological patterns: cases with polymorphic diffuse large B-cell lymphoma (29 cases), Hodgkin-like (8 cases) and polymorphic lymphoproliferative disorder-like (9 cases) patterns. One case was purely monomorphic diffuse large B-cell lymphoma. We show that this lymphoma type is a neoplasm with prominent classical and alternative nuclear factor-kB pathway activation in neoplastic cells (79% of the cases showed nuclear staining for p105/p50, 74% for p100/p52 and 63% for both proteins), with higher frequency than that observed in a control series of EBV-negative diffuse large B-cell lymphoma (χ2 <0.001). Most cases showed an activated phenotype (95% non-germinal center (Hans algorithm); 78% activated B cell (Choi algorithm)). Clonality testing demonstrated IgH and/or K/Kde/L monoclonal rearrangements in 64% of cases and clonal T-cell populations in 24% of cases. C-MYC (1 case), BCL6 (2 cases) or IgH (3 cases) translocations were detected by FISH in 18% cases. These tumors had a poor overall survival and progression-free survival (the estimated 2-year overall survival was 40±10% and the estimated 2-year progression-free survival was 36±9%). Thus, alternative therapies, based on the tumor biology, need to be tested in patients with EBV-positive diffuse large B-cell lymphoma of the elderly.

• Publisher: Elsevier Inc,Nature Publishing Group US,Elsevier Limited
• Subject: 692/699/67/1990/291/1621/1915 / 692/700/139/422 / 692/700/1518 / Age / Aged / Aged, 80 and over / Algorithms / B-cell lymphoma / Bcl-6 protein / Blotting, Western / c-Myc protein / Cancer / Disease-Free Survival / DLBCL / EBV / elderly / Epstein-Barr Virus Infections - complications / Fluorescence in situ hybridization / Geriatrics / Germinal Center - pathology / Heavy chains / Humans / Immune system / Immunoglobulins / Immunohistochemistry / In Situ Hybridization, Fluorescence / Laboratory Medicine / Lymphocytes / Lymphocytes B / Lymphocytes T / Lymphoma / Lymphoma, Large B-Cell, Diffuse - metabolism / Lymphoma, Large B-Cell, Diffuse - pathology / Lymphoma, Large B-Cell, Diffuse - virology / Medical prognosis / Medicine / Medicine & Public Health / Middle Aged / Neoplasm Staging / NF- Kappa B protein / NF-kappa B - metabolism / NFkB / non-Hodgkin lymphoma / original-article / Pathology / Patients / Retrospective Studies / Tissue Array Analysis / Translocation / Tumors