Bone marrow that is positive for Epstein-Barr virus encoded RNA-1 by in situ hybridization is related with a poor prognosis in patients with extranodal natural killer/T-cell lymphoma, nasal type.

Abstract

BACKGROUND AND OBJECTIVES:

Extranodal NK/T-cell lymphoma, nasal type is an aggressive lymphoma that is always associated with Epstein-Barr virus (EBV). This study was done to evaluate the use of EBV-encoded RNA-1 in situ hybridization (EBER-1 ISH) to detect occult micrometastasis in the bone marrow (BM) of patients with nasal NK/T-cell lymphoma.

DESIGN AND METHODS:

A total of 23 patients who underwent BM biopsy for routine pre-therapeutic evaluation were enrolled in the study. We used EBER-1 ISH to investigate the expression of EBER-1 in 30 BM specimens. The clinical correlation and therapeutic outcomes of these patients were analyzed. In addition, genomic analysis of EBV was performed in five patients.

RESULTS:

Conventional morphologic examinations failed to identify any lymphoma involvement in the 23 BM specimens obtained at initial staging. However, 10 of the 23 BM were positive for EBER-1. A lower survival rate was seen in patients with BM positive for EBER-1. Only the BM EBER-1 ISH result was shown to be an independent variable predicting overall survival in stage I and II patients (p=0.027; hazard ratio for death 0.066, 95% confidence interval, 0.006 to 0.733), suggesting that EBER-1 positivity in BM is the major determinant of a poor prognosis. However, discrepancies in the EBV strains between the primary tumor and BM existed in two of the five studied patients.

INTERPRETATION AND CONCLUSIONS:

We suggest that EBER-1 ISH should be performed on BM specimens of patients with nasal NK/T-cell lymphoma to identify the presence of EBER-1 positive cells, which appears to carry a poor prognosis. Whether or not the EBER-1 positive cells in the BM of nasal NK/T-cell lymphoma patients are true tumor cells requires further study.

• Authors: Wen-Tsung Huang, Kun-Chao Chang, Guan-Cheng Huang, Jenn-Ren Hsiao, Helen-H W Chen, Shih-Sung Chuang, Tsai-Yun Chen, Wu-Chou Su, Chao-Jung Tsao
• Journal: Haematologica (Haematologica) Vol. 90 Issue 8 Pg. 1063-9 (Aug 2005) ISSN: 1592-8721 [Electronic] Italy
• PMID: 16079105 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• DNA Primers
• Epstein-Barr virus encoded RNA 1
• RNA, Viral

Topics

• Adult
• Aged
• Bone Marrow Cells (pathology, virology)
• DNA Primers
• Female
• Herpesvirus 4, Human (genetics, isolation & purification)
• Humans
• In Situ Hybridization
• Killer Cells, Natural (immunology)
• Lymphoma, T-Cell (immunology, mortality, pathology)
• Male
• Middle Aged
• Neoplasm Staging
• Prognosis
• RNA, Viral (genetics)
• Retrospective Studies
• Survival Analysis