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EBV-positive PCNSL in older patients: incidence, characteristics, tumor pathology, and outcomes across a large multicenter cohort.

Prashasti AgrawalKevin A DavidZhengming ChenSuchitra SundaramSeo-Hyun KimRyan VacaYong LinSamuel SingerMary-Kate MalecekJordan CarterAdam Stephen ZayacMyung Sun KimNishitha ReddyDouglas NeyAlma HabibChristopher StrouseJerome J GraberVeronika BachanovaSidra SalmanJean A VendiolaNasheed HossainMazie TsangAjay MajorMaher K GandhiColm KeaneDavid A BondMatthew FolstadJulie ChangAngel Mier-HicksPallawi TorkaPriya RajakumarParameswaran VenugopalStephanie BergMichael GlantzSamuel A GoldlustRahul MatnaniPallavi KumarThomas A OllilaJohnny CaiStephen E SpurgeonAlex G SiegJoseph ClevelandNarendranath EpperlaReem KarmaliSeema NaikSonali M SmithJames L RubensteinBrad S KahlAmy ChadburnAndrew M EvensPeter Martin
Published in: Leukemia & lymphoma (2023)
The objective of this multicenter retrospective study was to examine the incidence, patient characteristics, pathology, and outcomes associated with Epstein-Barr virus (EBV)-related CNS lymphoma (CNSL) in older patients. Among 309 CNSL patients aged ≥60, 11.7% had EBV + tumors of which 72.2% were solid organ transplant (SOT)-related post-transplant lymphoproliferative disorders (PTLD). Younger age, SOT or autoimmune disease, and immunosuppressive treatment correlated highly with EBV-positivity. EBV + tumors were associated with absent C-MYC and BCL6 expression. EBV + PTLD was more likely to be associated with the absence of CD5 expression. EBV + non-PTLD had better median OS (not reached) compared to EBV + PTLD (10.8 months) and EBV-negative patients (43 months). Multivariable Cox regression analysis showed that age, performance status, and PTLD were negative predictors of OS. EBV status and immunosuppressive treatment were not correlated with OS. Our findings merit further investigation of EBV + PCNSL tumors and EBV-directed therapies.
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