Epstein-Barr virus

Plasmablastic Lymphoma in HIV-Positive Patients: A Literature Review and Results of a Russian Multi-Center Retrospective Study

AUTOIMMUNE THROMBOCYTOPENIA , ,

MO Popova1, IV Tsygankov1, YaV Gudozhnikova1, YuA Rogacheva1, NP Volkov1, KV Lepik1, MV Demchenkova2, MV Grigoreva2, AYu Efirkina2, TV Shneider3, YuV Kopeikina3, SA Stepanova3, VG Potapenko4, AV Klimovich4, NV Medvedeva4, MA Kolesnikova5, TI Pospelova5, NB Mikhailova1, VV Baikov1, AD Kulagin1

1 RM Gorbacheva Scientific Research Institute of Pediatric Oncology, Hematology and Transplantation; IP Pavlov First Saint Petersburg State Medical University, 6/8 L’va Tolstogo str., Saint Petersburg, Russian Federation, 197022

2 Irkutsk Regional Cancer Center, 32 Frunze str., Irkutsk, Russian Federation, 664035

3 Leningrad Regional Clinical Hospital, 45 bld. 2A Lunacharskogo pr-t, Saint Petersburg, Russian Federation, 194291

4 Municipal Clinical Hospital No. 31, 3 Dinamo pr-t, Saint Petersburg, Russian Federation, 197110

5 Municipal Center for Hematology, 21 Polzunova str., Novosibirsk, Russian Federation, 630051

For correspondence: Marina Olegovna Popova, MD, PhD, 6/8 L’va Tolstogo str., Saint Petersburg, Russian Federation, 197022; Tel.: +7(911)711-39-77; e-mail: marina.popova.spb@gmail.com

For citation: Popova MO, Tsygankov IV, Gudozhnikova YaV, et al. Plasmablastic Lymphoma in HIV-Positive Patients: A Literature Review and Results of a Russian Multi-Center Retrospective Study. Clinical oncohematology. 2022;15(1):28–41. (In Russ).

DOI: 10.21320/2500-2139-2022-15-1-28-41

ABSTRACT

Background. Plasmablastic lymphoma (PBL) is a rare lymphoproliferative disease which is almost exclusively associated with immunodeficiency. Most ample experience of chemotherapy and hematopoietic stem cells transplantation (HSCT) in this lymphoma variant has been accumulated in HIV-positive patients.

Aim. To describe the current approaches to PBL diagnosis and treatment in HIV-positive patients as well as to provide the results of the first multi-center retrospective study on PBL epidemiology and therapy efficacy in HIV-positive patients in the Russian Federation.

Materials & Methods. The study included 26 HIV-positive patients with PBL who were treated and followed-up at 5 Russian centers during 2012–2019. The present study is a part of multi-center retrospective study on lymphoma epidemiology in HIV-positive patients in Russia.

Results. PBL accounted for 9.5 % of all lymphomas in HIV-positive patients enrolled in multi-center retrospective study on lymphoma epidemiology in HIV-positive patients in Russia. Epidemiological characteristics of these patients corresponded to those described in previously published literature: the disease being diagnosed mainly at late stages (88 %), oral and nasal mucosa lesions with a common involvement of facial bones (65 %), and lack of optimal HIV-infection control (66.7 %). Most commonly, the patients received EPOCH-like treatment as first-line therapy (50 %). However, the efficacy of primary therapy appeared to be low. Overall survival (OS) and progression-free survival (PFS) during a year after first-line therapy onset was 57 % and 46 %, respectively. Bortezomib included in first-line therapy was associated with a trend to a more favorable prognosis. Half of patients showed a lymphoma relapse or progression after first-line therapy. Most used second-line regimen was DHAP. Overall response to second-line therapy was 38.5 %. After second-line therapy onset, 1-year OS and PFS were 26 % and 15 %, respectively.

Conclusion. HIV-positive patients with PBL have poor prognosis. Efforts to improve the prognosis for HIV-positive patients with PBL should be aimed at increasing the efficacy of first-line therapy and should involve the use of intensive chemotherapy regimens with bortezomib. The role of auto- and allo-HSCTs in the treatment of PBL has not been clearly determined, however, PBL patients, despite their HIV-infection, should be regarded as auto-HSCT-eligible in the first remission and allo-HSCT-eligible in case of relapse. Further prospective multi-center studies are needed to optimize the treatment of HIV-positive patients with PBL.

Keywords: plasmablastic lymphoma, HIV-infection, Epstein-Barr virus, MYC, PD-1/PD-L1/2, auto-HSCT, allo-HSCT, bortezomib, nivolumab, immunotherapy.

Received: July 20, 2021

Accepted: November 27, 2021

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Статистика Plumx английский

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Systemic Т-Cell Lymphoproliferative Disease Associated with Epstein-Barr Virus: A Literature Review and a Case Report

AUTOIMMUNE THROMBOCYTOPENIA , ,

EA Shalamova, AM Kovrigina, IA Shupletsova, EE Nikulina, VD Latyshev, NV Tsvetaeva

National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167

For correspondence: Alla Mikhailovna Kovrigina, PhD in Biology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167; e-mail: kovrigina.alla@gmail.com

For citation: Shalamova EA, Kovrigina AM, Shupletsova IA, et al. Systemic Т-Cell Lymphoproliferative Disease Associated with Epstein-Barr Virus: A Literature Review and a Case Report. Clinical oncohematology. 2021;14(4):477–87. (In Russ).

DOI: 10.21320/2500-2139-2021-14-4-477-487

ABSTRACT

Epstein-Barr virus (EBV) is ubiquitous, being identified in 90–95 % of adults. Its reactivation in immunodeficiency conditions often leads to clonal transformation of В-lymphocytes and development of В-cell lymphoproliferative diseases (LPD) and В-cell lymphomas. At the same time, in the countries of North-East and East Asia, as well as Latin America, non-immunocompromised patients sometimes demonstrate the development of EBV-associated Т-cell lymphoproliferative diseases. The present paper reports a rare case of EBV-associated systemic T-LPD with lymphadenopathy, splenomegaly as well as acute autoimmune hemolytic anemia in a man of Caucasian race. Complex analysis of anamnestic, pathomorphological, and laboratory data allowed to distinguish this disease from Т-cell lymphoma and choose the appropriate patient management strategy.

Keywords: lymphoproliferative disease, Epstein-Barr virus, EBV+ T-LPD, diagnosis, pathomorphology.

Received: May 30, 2021

Accepted: September 2, 2021

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Статистика Plumx английский

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Polymerase Chain Reaction for Prognosis Assessment and Monitoring of the Epstein-Barr Virus-Associated Hodgkin’s Lymphoma

LYMPHOID TUMORS , ,

MA Katin1, IV Zhil’tsov1, VM Semenov1, DK Novik2

1 Vitebsk State Medical University, 27 Frunze pr-t, Vitebsk, Republic of Belarus, 210023

2 Republican Applied Research Center for Radiation Medicine and Human Ecology, 290 Il’icha str., Gomel, Republic of Belarus, 246040

For correspondence: Prof. Ivan Viktorovich Zhil’tsov, MD, PhD, 27 Frunze pr-t, Vitebsk, Republic of Belarus, 210023; Tel.: +375(29)7104368-93-29; e-mail: zhyltsou@tut.by

For citation: Katin NA, Zhil’tsov IV, Semenov VM, Novik DK. Polymerase Chain Reaction for Prognosis Assessment and Monitoring of the Epstein-Barr Virus-Associated Hodgkin’s Lymphoma. Clinical oncohematology. 2018;11(2):182–6.

DOI: 10.21320/2500-2139-2018-11-2-182-186

ABSTRACT

The review provides the analysis of 34 papers on polymerase chain reaction (PCR) as a method of the Epstein-Barr virus (EBV) DNA detection in biological material of patients with EBV-associated cancer diseases including Hodgkin’s lymphoma (HL). A comparative analysis of different methods of EBV DNA detection in biological material is presented. EBV is associated with HL in 20 to 100 % of cases depending on a geographic region and HIV status. EBV-associated HLs are characterized by latency type II. EBV is found in all the atypical cells and can be detected in blood of EBV-associated HL patients by means of the PCR method. The review includes the results of studies on EBV detection using the PCR method compared to in situ methods of hybridization and immunohistochemistry in various EBV-associated cancer diseases including HL. The obtained data indicate that PCR can be used for quantitative determination of EBV DNA in blood plasma of HL patients for therapeutic efficacy monitoring and prognosis assessment of disease and relapses. Quantitative determination of EBV DNA in blood plasma of HL patients using the real time PCR method is a promising technique. Its further practical application requires standardization of the method, larger trials, and comparison to positron emission tomography.

Keywords: Epstein-Barr virus, Hodgkin’s lymphoma, polymerase chain reaction.

Received: December 20, 2017

Accepted: February 28, 2018

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Epstein-Barr Virus and Classical Hodgkin’s Lymphoma

REVIEWS , , , ,

VE Gurtsevich

N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

For correspondence: Vladimir Eduardovich Gurtsevich, DSci, Professor, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel.: +7(499)324-25-64; e-mail: gurvlad532@yahoo.com

For citation: Gurtsevitch VE. Epstein-Barr Virus and Classical Hodgkin’s Lymphoma. Clinical oncohematology. 2016;9(2):101–14 (In Russ).

DOI: 10.21320/2500-2139-2016-9-2-101-114

ABSTRACT

Among other oncogenic human viruses, the Epstein-Barr virus (EBV) drew special attention due to its unique properties. Being widespread among the population of the planet, the virus is also a leader in the number of associated different benign and malignant neoplasms of lymphoid and epithelial origin. The oncogenic potential of EBV is related to its ability to infect and transform human lymphocytes. In cases, when the interaction between reproduction of EBV, its latent state and immune control of the body is impaired, conditions for long-term proliferation of EBV-infected cells and their malignant transformation are formed. According to some investigators, the molecular mechanisms of EBV-associated carcinogenesis are due to the ability of the viral genome to promote the expression of series of products that simulate a number of growth factors and transcription and produce an anti-apoptotic effect. These products impair EBV-encoded signaling pathways that regulate a variety of cellular functions of homeostasis giving a cell the ability to proliferate indefinitely. However, the exact mechanism by which the EBV initiates tumor formation is not clear. The review provides summarized information on the structure and oncogenic potential of EBV, morphological and clinical cases of Hodgkin’s lymphoma (HL), and the role of EBV in the pathogenesis of types of HL associated with the virus. The review also dwells on the latest data on the use of EBV DNA plasma levels of patients with HL as a biomarker reflecting the effectiveness of the treatment performed and the prognosis of the disease.

Keywords: Epstein-Barr virus, EBV, latent membrane protein 1, LMP1, Hodgkin’s lymphoma, copies of EBV DNA.

Received: February 5, 2016

Accepted: February 8, 2016

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Secondary Hemophagocytic Syndrome in the Adult Patients. Literature Review and Authors’ Experience

RARE HEMATOLOGICAL TUMORS AND SYNDROMES , , , ,

VG Potapenko1,2, NA Potikhonova4, VV Baikov2, MB Belogurova1, IA Lisukov3, AV Klimovich1, SV Lapin2, MO Ivanova2, VM Kravtsova2, EI Podol’tseva1, NV Medvedeva1, BV Afanas’ev2

1 Municipal Clinical Hospital No. 31, 3 Dinamo pr-t, Saint Petersburg, Russian Federation, 197110

2 R.M. Gorbacheva Scientific Research Institute of Pediatric Hematology and Transplantation; Academician I.P. Pavlov First St. Petersburg State Medical University, 12 Rentgena str., Saint Petersburg, Russian Federation, 197022

3 I.I. Mechnikov North-Western State Medical University, 41 Kirochnaya str., Saint Petersburg, Russian Federation, 197022

4 Russian Scientific Research Institute of Hematology and Transfusiology under the Federal Medico-Biological Agency, 16 2-ya Sovetskaya str., Saint Petersburg, Russian Federation, 191024

For correspondence: Vsevolod Gennad’evich Potapenko, Municipal Clinical Hospital No. 31, 3 Dinamo pr-t, Saint Petersburg, Russian Federation, 197110; Tel.: +7(812)230-19-33; e-mail: potapenko.vsevolod@mail.ru

For citation: Potapenko V.G., Potikhonova N.A., Baikov V.V., Belogurova M.B., Lisukov I.A., Klimovich A.V., Lapin S.V., Ivanova M.O., Kravtsova V.M., Podol’tseva E.I., Medvedeva N.V., Afanas’ev B.V. Secondary Hemophagocytic Syndrome in the Adult Patients. Literature Review and Authors’ Experience. Klin. Onkogematol. 2015;8(2):169–84. (In Russ.).

ABSTRACT

Background & Aims. The hemophagocytic syndrome is a dangerous hyperinflammatory syndrome usually caused by an infection. It is a result of excessive cell activation in the mononuclear phagocyte system which is manifested itself through cytopenia, systemic inflammatory reaction, liver and spleen impairment. Since the disease is rare and its diagnosing is very complicated, this syndrome has not been studied thoroughly and is overlooked very often. The aim of this work is to describe authors’ experience in dealing with the secondary hemophagocytic syndrome (HPS) and to present a literature review.

Methods. Clinical and laboratory data of 15 patients aged 16 to 64 (median age 48 years) with secondary HPS observed over the period from 2009 till 2013 were analyzed. Secondary HPS was diagnosed in patients with malignant lymphoproliferative and infectious diseases. HPS signs were found in lymphoproliferative disorders (n = 5), chronic active EBV-infection (n = 3), allogeneic hematopoietic stem cell transplantation (n = 3), acute leukemia (n = 1), multiple myeloma (n = 1), pneumonia (n = 1), and glomerulonephritis (n = 1). 8 patients underwent treatment for HPS: etoposide (n = 1), glucocorticoids (n = 1), intravenous immunoglobulin (n = 2), combination of rituximab + glucocorticoids (n = 2), etoposide + cyclosporine A (n = 1), as well as combined HLH-2004 chemotherapy (n = 1). The median observation period was 42 months.

Results. Among 15 adult patients enrolled into the retrospective analysis, malignant lymphoproliferative disorders and chronic EBV-infection were most common underlying disorders in case of secondary HPS. Early diagnosing is very complicated, because diagnostic criteria accepted at present are typical for the late-phase HPS. The above factors require development of more sensitive and universal diagnostic criteria.

Conclusion. In oncohematological practice, the secondary HPS is a severe complication requiring differential diagnosing with other critical conditions and intensive care. In case of HPS associated with oncohematological disorders, patients require close monitoring throughout the antitumor treatment period and after it.

Keywords: secondary hemophagocytic syndrome, lymphoma, Epstein-Barr virus, etoposide, hematopoietic stem cells transplantation.

Received: December 9, 2014

Accepted: February 7, 2015

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