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Prognostic significance of CD20 expression and Epstein-Barr virus (EBV) association in classical Hodgkin lymphoma in Japan: a clinicopathologic study.
[hodgkin lymphoma, classical]
To
investigate
the
clinicopathological
significance
of
CD
2
0
expression
and
Epstein-
Barr
virus
(
EBV
)
association
in
Hodgkin
and
Reed
-
Sterberg
cells
of
classical
Hodgkin
lymphoma
(
CHL
)
,
CD
2
0
expression
and
EBV
positivity
(
by
EBER
in
situ
hybridization
)
were
investigated
in
389
CHL
patients
in
Japan
.
They
included
74
CD
2
0
-
positive
cases
(
19
%
)
and
315
CD
2
0
-
negative
cases
(
81
%
)
.
CD
2
0
-
positive
cases
showed
significantly
older
age
at
onset
(
P
=
0
.
018
)
and
higher
association
with
EBV
(
P
=
0
.
002
)
.
Multivariate
analysis
identified
EBV-positivity
(
but
not
CD
2
0
-
positivity
)
,
presence
of
B
symptoms
,
thrombocytopenia
,
elevated
serum
lactate
dehydrogenase
and
performance
status
>
1
as
poor
prognostic
factors
for
overall
survival
(
OS
)
.
We
constructed
a
new
prognostic
model
with
these
five
factors
classifying
patients
into
three
groups
:
low
risk
,
0
-
1
adverse
factor
;
intermediate
risk
,
2
-
3
factors
;
high
risk
,
4
-
5
factors
.
This
prognostic
model
could
stratify
the
prognosis
of
CHL
patients
(
P
<
0
.
0001
)
.
For
144
patients
(
58
%
)
classified
into
the
low
-risk
group
,
the
5
-
year
OS
was
91
%
.
For
92
patients
(
37
%
)
in
the
intermediate
group
,
the
5
-
year
OS
was
66
%
;
for
11
patients
(
5
%
)
in
the
high
-risk
group
,
the
5
-
year
OS
was
36
%
.
In
conclusion
,
EBV
is
identified
as
an
independent
poor
prognostic
factor
for
CHL
patients
.
Therefore
,
examination
of
EBV
association
in
CHL
is
recommended
as
routine
pathologic
practice
especially
in
countries
where
EBV
infection
prevails
.
Diseases
Validation
Diseases presenting
"poor prognostic factors"
symptom
hodgkin lymphoma, classical
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