Effect of Epstein-Barr virus infection on response to chemotherapy and survival in Hodgkin's disease

We have analyzed paraffin sections from 190 patients with histologically co nfirmed Hodgkin's disease (HD) for the presence of Epstein-Barr virus (EBV) using in situ hybridization to detect the EBV-encoded Epstein Barr virus e arly RNAs (EBERs) and immunohistochemistry to identify latent membrane prot ein-1 (LMP1) expression. EBV was present in the tumor cells in 51 HD cases (27%) and was mainly confined to the mixed cellularity and nodular sclerosi s subtypes. There was no difference between EBV-positive and EBV-negative H D patients with regard to age, clinical stage, presentation, and the number of alternating chemotherapy cycles of ChIVPP and PABIOE received. The comp lete remission rate after study chemotherapy was 80% in EBV positive patien ts versus 69% in EBV-negative patients (P = .05). The 2-year failure-free s urvival rate was significantly better for EBV-positive patients when compar ed with the EBV-negative HD group (P = .02), Although 2-year and 5-year ove rall survival rates were better for EBV-positive HD patients, the differenc es were not statistically significant (P = .18 and P = .40, respectively). In conclusion, the results confirm the favorable prognostic value of EBV in the tumor cells of HD patients and suggest important differences in respon se to chemotherapy between EBV-positive and EBV negative patients. (C) 1999 by The American Society of Hematology.