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Dynamic changes in circulating EBV-DNA load during treatment have prognostic values in EBV+ DLBCL-NOS: a Chinese cohort study

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Abstract

EBV-positive diffuse large B-cell lymphoma, not otherwise specified (EBV+ DLBCL-NOS), is an EBV-positive clonal B-cell lymphoid proliferation and circulating EBV-DNA is a great indicator for prognosis among EBV associated disease. In this retrospective study, we report 66 EBV+ DLBCL cases among 2137 DLBCL-NOS cases diagnosed from 2013 to 2021 (prevalence of 6.0%). After a median follow-up of 27 months, progression-free survival (PFS) and overall survival (OS) at 2 years were 39.5% ± 6.2% and 53.6% ± 6.4%, respectively. Multivariate analysis showed that only the biomarker of the positivity of post treatment EBV-DNA had a borderline correlation with shorter PFS and OS (PFS: P = 0.053; OS: P = 0.065). Patients were divided into three subgroups according to dynamic changes of EBV-DNA status: EBV-DNA persistently negative group, EBV-DNA persistently positive group, and EBV-DNA transformed from positive to negative group; among the three groups, patients of the persistently positive group had worst PFS and OS (P = 0.0527 and P = 0.0139, respectively). Decline in EBV copies correlated significantly with treatment response as well. In conclusion, circulating EBV-DNA level played a vital role in prognostic and monitoring marker for EBV+ DLBCL-NOS.

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Data availability

The data generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

This study was supported by the National Natural Science Foundation of China (grants 81770166, 81700193, 82170186, and 81720108002), Jiangsu Province’s Medical Elite Programme (ZDRCA2016022), Project of the National Key Clinical Specialty, the Jiangsu Provincial Special Program of Medical Science (BE2017751), the National Science and Technology Major Project (2018ZX09734007), the China Postdoctoral Science Foundation (2021M691336), and the Jiangsu Postdoctoral Science Foundation (2021K083A).

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Author notes

  1. Tong-Yao Xing and Zi-Wen Duan contributed equally to this work.

Authors and Affiliations

  1. Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China

    Tong-Yao Xing, Zi-Wen Duan, Wei-Ting Wang, Kai-Xin Du, Hao-Rui Shen, Hua Yin, Jia-Zhu Wu, Yue Li, Li Wang, Jian-Yong Li, Jin-Hua Liang & Wei Xu

  2. Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China

    Jin-Hua Liang & Wei Xu

  3. Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China

    Jin-Hua Liang & Wei Xu

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  1. Tong-Yao Xing
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Contributions

Tong-Yao Xing, Zi-Wen Duan, Jia-Zhu Wu, Yue Li and Li Wang: Conceptualization, methodology, data curation, formal analysis, writing-original draft, and visualization.

Wei-Ting Wang, Kai-Xin Du, Hao-Rui Shen and Hua Yin: Data curation, formal analysis, and visualization. Tong-Yao Xing, Zi-Wen Duan and Jin-Hua Liang: Conceptualization, writing-review & editing, and supervision. Wei Xu and Jian-Yong Li: Conceptualization, methodology, funding acquisition, supervision, writing-review & editing.

Corresponding authors

Correspondence to Jin-Hua Liang or Wei Xu.

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The authors declare no conflict of interest.

Tong-Yao Xing, Zi-Wen Duan, Wei-Ting Wang, Kai-Xin Du, Hao-Rui Shen, Hua Yin, Jia-Zhu Wu, Yue Li, Li Wang, Jia-Yong Li, Jin-Hua Liang, Wei Xu.

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Xing, TY., Duan, ZW., Wang, WT. et al. Dynamic changes in circulating EBV-DNA load during treatment have prognostic values in EBV+ DLBCL-NOS: a Chinese cohort study. Ann Hematol 102, 2471–2481 (2023). https://doi.org/10.1007/s00277-023-05260-z

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