The prognostic value of Epstein−Barr virus infection in Hodgkin lymphoma: A systematic review and meta-analysis
IntroductionEpstein−Barr virus (EBV) contributes significantly to the development and occurrence of B-cell lymphomas. However, the association between EBV infection status and clinical outcomes in Hodgkin lymphoma (HL) patients has long been controversial. Therefore, we aimed to estimate the prognos...
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| Format: | Article |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.1034398/full |
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| author | Jianyu Hu Xue Zhang Huan Tao Yongqian Jia |
| author_facet | Jianyu Hu Xue Zhang Huan Tao Yongqian Jia |
| author_sort | Jianyu Hu |
| collection | DOAJ |
| description | IntroductionEpstein−Barr virus (EBV) contributes significantly to the development and occurrence of B-cell lymphomas. However, the association between EBV infection status and clinical outcomes in Hodgkin lymphoma (HL) patients has long been controversial. Therefore, we aimed to estimate the prognostic significance of EBV infection in HL survival.MethodsWe searched PubMed, Embase, Web of Science, and the Cochrane Library for relevant cohort studies from the date of their inception to February 20, 2022. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS), Failure-free survival (FFS), Progression-free survival (PFS), Event-free survival (EFS) and disease-specific survival (DSS) were extracted from the studies or calculated. Subgroup analyses were conducted independently on the five survival outcomes to investigate the source of heterogeneity.ResultsA total of 42 qualified studies involving 9570 patients were identified in our meta-analysis. There was an association between EBV positivity and significantly poorer OS (HR=1.443, 95% CI: 1.250-1.666) and DSS (HR=2.312, 95% CI: 1.799-2.972). However, the presence of EBV in HL showed no effect on FFS, PFS or EFS. In subgroup analyses of OS, DSS and FFS stratified by age groups, EBV positivity was associated with poorer prognosis in elderly patients. Meanwhile, in children and adolescents with EBV-positive HL, we also observed a trend toward a better prognosis, though the results were not statistically significant.ConclusionsEBV-positive status is associated with poor OS and DSS in HL patients. EBV infection should therefore be considered a valuable prognostic marker and risk-stratifying factor in HL, especially in older patients.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022328708. |
| first_indexed | 2024-04-12T01:28:19Z |
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| id | doaj.art-35c3e476fd834dfcb21b64af4f15f646 |
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| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-12T01:28:19Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj.art-35c3e476fd834dfcb21b64af4f15f6462022-12-22T03:53:33ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-10-011210.3389/fonc.2022.10343981034398The prognostic value of Epstein−Barr virus infection in Hodgkin lymphoma: A systematic review and meta-analysisJianyu HuXue ZhangHuan TaoYongqian JiaIntroductionEpstein−Barr virus (EBV) contributes significantly to the development and occurrence of B-cell lymphomas. However, the association between EBV infection status and clinical outcomes in Hodgkin lymphoma (HL) patients has long been controversial. Therefore, we aimed to estimate the prognostic significance of EBV infection in HL survival.MethodsWe searched PubMed, Embase, Web of Science, and the Cochrane Library for relevant cohort studies from the date of their inception to February 20, 2022. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS), Failure-free survival (FFS), Progression-free survival (PFS), Event-free survival (EFS) and disease-specific survival (DSS) were extracted from the studies or calculated. Subgroup analyses were conducted independently on the five survival outcomes to investigate the source of heterogeneity.ResultsA total of 42 qualified studies involving 9570 patients were identified in our meta-analysis. There was an association between EBV positivity and significantly poorer OS (HR=1.443, 95% CI: 1.250-1.666) and DSS (HR=2.312, 95% CI: 1.799-2.972). However, the presence of EBV in HL showed no effect on FFS, PFS or EFS. In subgroup analyses of OS, DSS and FFS stratified by age groups, EBV positivity was associated with poorer prognosis in elderly patients. Meanwhile, in children and adolescents with EBV-positive HL, we also observed a trend toward a better prognosis, though the results were not statistically significant.ConclusionsEBV-positive status is associated with poor OS and DSS in HL patients. EBV infection should therefore be considered a valuable prognostic marker and risk-stratifying factor in HL, especially in older patients.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022328708.https://www.frontiersin.org/articles/10.3389/fonc.2022.1034398/fullEpstein – Barr virusHodking's lymphomaMeta - analysisprognosisVirus infection |
| spellingShingle | Jianyu Hu Xue Zhang Huan Tao Yongqian Jia The prognostic value of Epstein−Barr virus infection in Hodgkin lymphoma: A systematic review and meta-analysis Frontiers in Oncology Epstein – Barr virus Hodking's lymphoma Meta - analysis prognosis Virus infection |
| title | The prognostic value of Epstein−Barr virus infection in Hodgkin lymphoma: A systematic review and meta-analysis |
| title_full | The prognostic value of Epstein−Barr virus infection in Hodgkin lymphoma: A systematic review and meta-analysis |
| title_fullStr | The prognostic value of Epstein−Barr virus infection in Hodgkin lymphoma: A systematic review and meta-analysis |
| title_full_unstemmed | The prognostic value of Epstein−Barr virus infection in Hodgkin lymphoma: A systematic review and meta-analysis |
| title_short | The prognostic value of Epstein−Barr virus infection in Hodgkin lymphoma: A systematic review and meta-analysis |
| title_sort | prognostic value of epstein barr virus infection in hodgkin lymphoma a systematic review and meta analysis |
| topic | Epstein – Barr virus Hodking's lymphoma Meta - analysis prognosis Virus infection |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.1034398/full |
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