Age cutoff for Epstein-Barr virus-positive diffuse large B-cell lymphoma–is it necessary?
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AuthorOk, Chi Young; Ye, Qing; Li, Ling; Manyam, Ganiraju C.; Deng, Lijuan; Goswami, Rashmi R.; Wang, Xiaoxiao; Montes Moreno, Santiago; Visco, Carlo; Tzankov, Alexandar; Dybkaer, Karen; Zhang, Li; Abramson, Jeremy; Sohani, Aliyah R.; Chiu, April; Orazi, Attilio; Zu, Youli; Bhagat, Govind; Piris Pinilla, Miguel Ángel; [et al.]
Epstein-Barr virus-positive diffuse large B-cell lymphoma of the elderly (EBV+ DLBCL-e) is a molecularly distinct variant of DLBCL, characterized by a monoclonal B-cell proliferation that occurs in patients >50 years of age without a history or clinicopathologic evidence of immunodeficiency. However, patients with EBV+ DLBCL younger than 50-years-old also exist in Western countries. We evaluated the clinicopathologic, immunophenotypic and genetic features in Cacausian patients with EBV+ DLBCL who are ≤50 years of age and compared this patient group to patients who are >50 years. In patients who are ≤50 years, less frequent expression of BCL6 and a trend of more frequent expression of CD30 and pSTAT3 were found in patients with EBV+ DLBCL. In patients who are >50 years, common expression of CD30, p50, pSTAT3 and less frequent expression of BCL6 were observed. Older patients also more commonly had a poor performance status (ECOG≥2). Comparing EBV+ DLBCL patients in ≤50 years versus >50 years, both groups had similar clinicopathologic, immunophenotypic and genetic features. Gene expression profiling, microRNA profiling and treatment outcome of the younger patients with EBV+ DLBCL was not distinctive from tumors in older patients. Based on our data, we suggest that the arbitrary age cutoff for EBV+ DLBCL is unnecessary and should be eliminated in the WHO lymphoma classification scheme.
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