EBV‐positive diffuse large B‐cell lymphoma, not otherwise specified: 2018 update on diagnosis, risk‐stratification and management

• Autores: Castillo, Jorge J., Beltran, Brady E., Miranda, Roberto N., Young, Ken H., Chavez, Julio C., Sotomayor, Eduardo M.
• Formato: artículo
• Fecha de Publicación: 2018
• Institución: Universidad de San Martín de Porres
• Repositorio: USMP-Institucional
• Lenguaje: inglés
• OAI Identifier: oai:repositorio.usmp.edu.pe:20.500.12727/6261
• Enlace del recurso: https://hdl.handle.net/20.500.12727/6261; https://doi.org/10.1002/ajh.25112
• Nivel de acceso: acceso abierto
• Materia: Diagnóstico diferencial; Herpesvirus humano 4; Linfoma de células B grandes difuso; Pronóstico; Medición de riesgo; Factores de riesgo; https://purl.org/pe-repo/ocde/ford#3.02.00

Disease overview Epstein Barr virus‐positive (EBV+) diffuse large B‐cell lymphoma (DLBCL), not otherwise specified (NOS) is an entity included in the 2016 WHO classification of lymphoid neoplasms. EBV+ DLBCL, NOS, is an aggressive B‐cell lymphoma associated with chronic EBV infection, and a poor prognosis with standard chemotherapeutic approaches. Diagnosis The diagnosis is made through a careful pathological evaluation. Detection of EBV‐encoded RNA is considered standard for diagnosis; however, a clear cutoff for positivity has not been defined. The differential diagnosis includes plasmablastic lymphoma, DLBCL associated with chronic inflammation, primary effusion lymphoma, HHV8+ DLBCL, NOS, and EBV+ mucocutaneuos ulcer. Risk‐stratification The International prognostic index (IPI) and the Oyama score can be used for risk‐stratification. The Oyama score includes age >70 years and presence of B symptoms. The expression of CD30 is emerging as a potential adverse, and targetable, prognostic factor. Management Patients with EBV+ DLBCL, NOS, should be staged and managed following similar guidelines than patients with EBV‐negative DLBCL. EBV+ DLBCL, NOS, however, has a worse prognosis than EBV‐negative DLBCL in the era of chemoimmunotherapy. There is an opportunity to study and develop targeted therapy in the management of patients with EBV+ DLBCL, NOS.