Pediatric Hodgkin lymphoma in two South American Series: a distinctive epidemiological pattern and lack of association of Epstein Barr virus with clinical outcome

MAGALHÃES BARROS, M; PAOLA ANDREA CHABAY; HASSAN, R.; DEL LAGO A; DE MATTEO E; CARRICO MK; REY G; ZALCBERG, I.; PRECIADO MV

Colonia

Congreso; 7th International Symposium on Hodgkin Lymphoma; 2007

European Hematology Association

Hodgkin lymphoma (HL) shows a bimodal distribution with a first peak in developing countries during childhood. The causative role and prognostic significance of Epstein Barr virus (EBV) association in patients with HL is controversial. Our aim was to perform a comparative study of EBV association in two Latin American pediatric HL series, and to correlate it with patient´s survival. EBERs in situ hibridization and LMP1 immunohistochemistry were performed on formalin-fixed paraffinembedded HL biopsies from 176 pediatric patients from 2 public institutions from Argentina and Southeast Brazil. All the patients received antracycline-based treatments. The median age of Argentine patients was 8 years (2-18) while in Brazilian patients was 14 years (3-18). MC subtype was prevalent in Argentine HL (52%), and NS subtype in Brazilian HL (83%). EBV expression was detected in 52% of cases, namely 54% Argentine HL and 48% Brazilian HL. EBV was significantly associated with MC subtype in both populations. In Argentine HL, EBV positivity was significantly higher in patients <10 years (p=0.0011). Event free survival did not attain statistical significance neither in Argentine HL p=0.5317), nor in Brazilian HL (p=0.8321). Our results do not support EBV association stated for pediatric HL in developing countries. Correlation of younger age with EBV infection only in Argentine patients might be related to a different age background. Our findings give further support the fact that HL is a heterogeneous disease and that the epidemiological models proposed in the last decade need to be refined to include new and contrasting evidences. In our pediatric series, EBV status cannot be used as prognostic factor.