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<p>Epstein-Barr virus-encoded small RNA (EBER), a hallmark of EBV infection, is a poor prognostic factor in peripheral T-cell lymphoma (PTCL). Current clinical-based prognostic scores inadequately identify high-risk EBER-positive patients or guide therapy, underscoring the need for improved risk-stratification and treatment strategies. This multicenter cohort study, encompassing 167 PTCL patients, systematically analyzed the impact of EBER status on patient survival and treatment response. Utilizing LASSO-penalized Cox regression, a novel prognostic risk scoring system was developed incorporating EBER status and clinical indicators. With a median follow-up of 22.1&#xa0;months, 63 patients (38%) died. The objective response rate was 57%. EBER-positive status was associated with older age, hypoalbuminemia, high IPI scores, shorter median overall survival (mOS), higher positivity rates for CD30, CD4, BCL6, PD-1, and poorer response to first-line chemotherapy. Multivariate analysis identified independent adverse prognostic factors (<i>p</i> &lt; 0.05): Albumin &lt; 40, Platelet-to-Monocyte Ratio ≤ 300, Lactate Dehydrogenase &gt; 250, Age &gt; 70, and EBER-positivity. A prognostic model incorporating these factors stratified patients into three significantly distinct risk groups (<i>p</i> &lt; 0.001): Low-risk (<i>n</i> = 45; 3-year OS 87.6%, mOS not reached), Intermediate-risk (<i>n</i> = 60; 3-year OS 49.7%, mOS 32.8&#xa0;months), High-risk (<i>n</i> = 62; 3-year OS 25.1%, mOS 14.3&#xa0;months). The model outperformed existing models and demonstrated excellent discrimination, stability, clinical utility across PTCL subgroups. This novel prognostic score, integrating subtype-specific marker and clinical features, provides a refined framework for precise PTCL risk stratification and treatment guidance.</p>

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Epstein-barr virus-encoded small RNA incorporated prognostic model enables precision risk stratification and guides treatment decisions in peripheral t-cell lymphoma: a multicenter retrospective cohort

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月12日

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  • Ze-Tao Chen,
  • Ling Huang,
  • Han-Guo Guo,
  • Cai-Di Lin,
  • Xin-Miao Jiang,
  • Xiao-Juan Wei,
  • Fei-Li Chen,
  • Si-Chu Liu,
  • Hong Zhang,
  • Zhan-Li Liang,
  • Ning Wang,
  • Xiao-Dan Zhang,
  • Li-E. LIN,
  • Ting-Bo Liu,
  • Ji-Hao Zhou,
  • Zhi-Gang Peng,
  • Wen-Yu Li

摘要

Epstein-Barr virus-encoded small RNA (EBER), a hallmark of EBV infection, is a poor prognostic factor in peripheral T-cell lymphoma (PTCL). Current clinical-based prognostic scores inadequately identify high-risk EBER-positive patients or guide therapy, underscoring the need for improved risk-stratification and treatment strategies. This multicenter cohort study, encompassing 167 PTCL patients, systematically analyzed the impact of EBER status on patient survival and treatment response. Utilizing LASSO-penalized Cox regression, a novel prognostic risk scoring system was developed incorporating EBER status and clinical indicators. With a median follow-up of 22.1 months, 63 patients (38%) died. The objective response rate was 57%. EBER-positive status was associated with older age, hypoalbuminemia, high IPI scores, shorter median overall survival (mOS), higher positivity rates for CD30, CD4, BCL6, PD-1, and poorer response to first-line chemotherapy. Multivariate analysis identified independent adverse prognostic factors (p < 0.05): Albumin < 40, Platelet-to-Monocyte Ratio ≤ 300, Lactate Dehydrogenase > 250, Age > 70, and EBER-positivity. A prognostic model incorporating these factors stratified patients into three significantly distinct risk groups (p < 0.001): Low-risk (n = 45; 3-year OS 87.6%, mOS not reached), Intermediate-risk (n = 60; 3-year OS 49.7%, mOS 32.8 months), High-risk (n = 62; 3-year OS 25.1%, mOS 14.3 months). The model outperformed existing models and demonstrated excellent discrimination, stability, clinical utility across PTCL subgroups. This novel prognostic score, integrating subtype-specific marker and clinical features, provides a refined framework for precise PTCL risk stratification and treatment guidance.