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Annals of Oncology 14:282-290, 2003
© 2003 European Society for Medical Oncology

Original Paper

The effect of Epstein–Barr virus status on outcome in age- and sex-defined subgroups of patients with advanced Hodgkin’s disease

K. J. Flavell1, L. J. Billingham2,+, J. P. Biddulph3, L. Gray2, J. R. Flavell4, C. M. Constandinou1, L. S. Young2 and P. G. Murray4

1 School of Health Sciences, University of Wolverhampton, Wolverhampton; 2 Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham; 3 Department of Primary Care and Population Sciences, University College London, Royal Free Campus, London; 4 Department of Pathology, Division of Cancer Studies, University of Birmingham, Birmingham, UK

Received 28 February 2002; revised 4 September 2002; accepted 17 September 2002

Background:

Conflicting data on the effect of the Epstein–Barr virus (EBV) on outcome in Hodgkin’s disease (HD) might be due to the heterogeneous nature of this disease. In this study we have investigated whether the effect of EBV status on outcome is different between aetiologically defined age groups (15–34, 35–44, 45+ years) and also between males and females.

Patients and methods:

Paraffin-embedded sections from 273 patients with advanced HD from two related clinical trials were analysed for the presence of EBV using in situ hybridisation.

Results:

EBV was detected in 78 (29%) of cases. For all patients, after a median follow-up of 5 years, there were no significant differences in survival by EBV status although there was a trend towards longer failure-free survival times for EBV-positive patients. Multivariate analyses suggested that EBV and sex, when in combination, were prognostic factors for failure-free survival (P = 0.06 for both). For subgroups, the effect of EBV on failure-free survival was significant for males and 15–34 years age group (P = 0.05 and P = 0.03, respectively).

Conclusion:

This study suggests that with a median follow-up of 5 years, EBV status does not affect survival but being EBV-positive may be beneficial in terms of failure-free survival, particularly for males and younger adults.

Key words: Epstein–Barr virus, Hodgkin’s disease, subgroup analysis, survival


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