Epstein–Barr Virus Association and Prognosis in Taiwanese Hodgkin Lymphoma: A Nationwide Multicenter Study With Comparison to United States Whites
Year: 2026
Type: article
Abstract: Hodgkin lymphoma (HL) is associated with Epstein-Barr virus (EBV) infection in a subset of cases. We previously showed that the incidence of HL in Taiwan increased ~2.5-fold between 2001 and 2020, particularly among young women with the nodular sclerosis (NS) subtype. In this nationwide multicenter study, we evaluated EBV status in HL to determine its impact on clinicopathologic features and survival outcomes. We found that the proportion of EBV-associated HL in Taiwan declined over the past two decades, from 39% to 27%. EBV-positive frequency exhibited a bimodal age distribution, peaking in children < 10 years (63%) and adults > 70 years (80%), with the lowest frequency in patients 20-29 years (11%). Compared with EBV-negative patients, EBV-positive patients were older (53.5 vs. 32.9 years; p < 0.001), predominantly male (73.1% vs. 48.7%; p < 0.001), more likely to have nodal disease (83.3% vs. 74.2%; p = 0.003) and mixed cellularity histology (37.1% vs. 11.4%; p < 0.001), and had inferior 10-year survival (56.3% vs. 85.7%; p < 0.001). Adverse prognostic factors in HL included older age (> 60 years), B symptoms, non-NS histology, EBV-positivity, advanced-stage disease (Stage III-IV), and a high International Prognostic Score (IPS, 4-7). On multivariate analysis, older age and a high IPS retained prognostic significance. Large registry datasets from Taiwan and the US further demonstrated that survival outcomes have improved over the past two decades. Female patients and those with the NS and nodular lymphocyte-predominant subtypes had significantly better survival. These findings provide insight into the biological impact of EBV in HL and help inform strategies for disease prevention and management.
Source: International Journal of Cancer
DOI: 10.1002/ijc.70780
Institutions: National Cheng Kung University Hospital, National Cheng Kung University, National Taiwan University Hospital, National Taiwan University, China Medical University, China Medical University Hospital, Taichung Veterans General Hospital, Kaohsiung Medical University, Kaohsiung Medical University Chung-Ho Memorial Hospital, Taipei Medical University-Shuang Ho Hospital, Taipei Medical University, Linkou Chang Gung Memorial Hospital, Tri-Service General Hospital, National Defense Medical Center, Taipei Veterans General Hospital, Mackay Memorial Hospital, Chung Shan Medical University Hospital, Chung Shan Hospital, Tzu Chi Foundation, Hualien Tzu Chi Medical Center, The University of Texas MD Anderson Cancer Center
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7222804193