Improved prognosis of Epstein-Barr virus associated childhood Hodgkin's lymphoma: study of 47 South African cases

Aim-To study the distribution of Hodgkin's lymphoma in South African childr en and report the incidence of Epstein-Barr virus (EBV) as regards age, rac e, sex, and histological subtype; to investigate whether EBV is relevant to survival. Methods-Immunohistochemistry (IHC) and in situ hybridisation (ISH) to detec t EBV were performed on 47 South African children with classical Hodgkin's lymphoma, ranging in age from 3 to 14 years and coming from different ethni c backgrounds. The correlation between the presence of the virus and clinic al outcome was assessed. Results-The nodular sclerosing subtype predominated, comprising 89% of case s; the remaining 11% were of the mixed cellularity subtype. EBV was present in 68%, Full clinical data were available for 36 cases; EBV positive patie nts presented with less aggressive symptoms at diagnosis and had a signific antly longer median survival than EBV negative patients. Conclusions-The distribution of EBV in South African childhood Hodgkin's ly mphoma follows a pattern intermediate to that of industrialised and nonindu strialised countries. Furthermore, our data suggest that there is an associ ation between poor prognosis and the non-detection of EBV products in South African childhood Hodgkin's lymphoma.