Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
Diffuse large B-cell lymphoma in a South African cohort with a high HIV prevalence: an analysis by cell-oforigin, Epstein-Barr virus infection and survival
Introduction: Diffuse large B-cell lymphoma, not otherwise specified (DLBCL NOS) is subdivided according to the cell-of-origin (COO) classification into germinal centre B-cell (GCB) and activated B-cell (ABC) subtypes, each with different molecular profiles and clinical behaviour. This study aims to...
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
Department of Clinical Laboratory Sciences
2022
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867613321894559744 |
|---|---|
| access_status_str | Open Access |
| author | Cassim, Sumaiya |
| author2 | Antel, Katherine |
| author_browse | Antel, Katherine Cassim, Sumaiya |
| author_facet | Antel, Katherine Cassim, Sumaiya |
| author_sort | Cassim, Sumaiya |
| collection | Thesis |
| description | Introduction: Diffuse large B-cell lymphoma, not otherwise specified (DLBCL NOS) is subdivided according to the cell-of-origin (COO) classification into germinal centre B-cell (GCB) and activated B-cell (ABC) subtypes, each with different molecular profiles and clinical behaviour. This study aims to describe the pattern of the COO subtypes, the proportion of Epstein-Barr virus (EBV) co-infection, and their influence on survival outcomes in a setting of high HIV prevalence. Materials and Methods: This retrospective cohort study included patients diagnosed with de novo DLBCL NOS at our tertiary academic centre in Cape Town, South Africa over a 14-year period. Immunohistochemical stains were performed for COO classification, according to the Hans algorithm. Tumour EBV co-infection was established by EBV-encoded ribonucleic acid in situ hybridisation (EBER-ISH) staining. The effect of the COO subtypes and EBV co-infection on overall survival were described by means of univariate, bivariate and multivariate analyses. Results: A total of 181 patients with DLBCL NOS were included, which comprised 131 HIV-uninfected and 50 HIV-infected patients. There was an equal distribution of GCB and ABC subtypes in the HIV-infected and HIV-uninfected groups. EBV co-infection was detected in 16% of the HIV-infected cases and in 7% of the HIV-uninfected cases (p=0.09). There was no significant difference in the incidence of EBV co-infection between the GCB and ABC subtypes (p=0.67). HIV-infected patients with CD4≥150 cells/mm3 had similar survival to HIV-uninfected patients (p=0.005). Multivariate regression analysis showed that in the HIVinfected group with marked immunosuppression (CD4 <150 cells/mm3), there was significantly poorer overall survival compared to the HIV-uninfected group (HR 2.4, 95% CI 1.3–4.1). There were no statistically significant differences in overall survival by DLBCL COO subtype. Conclusions: There was no difference in the proportion of DLBCL COO subtypes, regardless of HIV status. EBV co-infection was more common in the HIV-infected group, but less than described in the literature. Unexpectedly, there were no significant differences in survival outcomes between the GCB and ABC subtypes. Higher CD4 counts in the HIV-infected group had good survival outcomes, while lower CD4 counts predicted adverse survival outcomes. Further research is needed to explore the genetic mutational landscape of HIVassociated DLBCL. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/36418 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:34:17.944Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Department of Clinical Laboratory Sciences |
| publisherStr | Department of Clinical Laboratory Sciences |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/36418 Diffuse large B-cell lymphoma in a South African cohort with a high HIV prevalence: an analysis by cell-oforigin, Epstein-Barr virus infection and survival Cassim, Sumaiya Antel, Katherine Verburgh Estelle B-cell lymphoma DLBCL NOS HIV-infected HIV South Africa Introduction: Diffuse large B-cell lymphoma, not otherwise specified (DLBCL NOS) is subdivided according to the cell-of-origin (COO) classification into germinal centre B-cell (GCB) and activated B-cell (ABC) subtypes, each with different molecular profiles and clinical behaviour. This study aims to describe the pattern of the COO subtypes, the proportion of Epstein-Barr virus (EBV) co-infection, and their influence on survival outcomes in a setting of high HIV prevalence. Materials and Methods: This retrospective cohort study included patients diagnosed with de novo DLBCL NOS at our tertiary academic centre in Cape Town, South Africa over a 14-year period. Immunohistochemical stains were performed for COO classification, according to the Hans algorithm. Tumour EBV co-infection was established by EBV-encoded ribonucleic acid in situ hybridisation (EBER-ISH) staining. The effect of the COO subtypes and EBV co-infection on overall survival were described by means of univariate, bivariate and multivariate analyses. Results: A total of 181 patients with DLBCL NOS were included, which comprised 131 HIV-uninfected and 50 HIV-infected patients. There was an equal distribution of GCB and ABC subtypes in the HIV-infected and HIV-uninfected groups. EBV co-infection was detected in 16% of the HIV-infected cases and in 7% of the HIV-uninfected cases (p=0.09). There was no significant difference in the incidence of EBV co-infection between the GCB and ABC subtypes (p=0.67). HIV-infected patients with CD4≥150 cells/mm3 had similar survival to HIV-uninfected patients (p=0.005). Multivariate regression analysis showed that in the HIVinfected group with marked immunosuppression (CD4 <150 cells/mm3), there was significantly poorer overall survival compared to the HIV-uninfected group (HR 2.4, 95% CI 1.3–4.1). There were no statistically significant differences in overall survival by DLBCL COO subtype. Conclusions: There was no difference in the proportion of DLBCL COO subtypes, regardless of HIV status. EBV co-infection was more common in the HIV-infected group, but less than described in the literature. Unexpectedly, there were no significant differences in survival outcomes between the GCB and ABC subtypes. Higher CD4 counts in the HIV-infected group had good survival outcomes, while lower CD4 counts predicted adverse survival outcomes. Further research is needed to explore the genetic mutational landscape of HIVassociated DLBCL. 2022-05-18T12:28:04Z 2022-05-18T12:28:04Z 2022 2022-05-18T12:27:22Z Master Thesis Masters MMed http://hdl.handle.net/11427/36418 eng application/pdf Department of Clinical Laboratory Sciences Faculty of Health Sciences |
| spellingShingle | B-cell lymphoma DLBCL NOS HIV-infected HIV South Africa Cassim, Sumaiya Diffuse large B-cell lymphoma in a South African cohort with a high HIV prevalence: an analysis by cell-oforigin, Epstein-Barr virus infection and survival |
| thesis_degree_str | Master's |
| title | Diffuse large B-cell lymphoma in a South African cohort with a high HIV prevalence: an analysis by cell-oforigin, Epstein-Barr virus infection and survival |
| title_full | Diffuse large B-cell lymphoma in a South African cohort with a high HIV prevalence: an analysis by cell-oforigin, Epstein-Barr virus infection and survival |
| title_fullStr | Diffuse large B-cell lymphoma in a South African cohort with a high HIV prevalence: an analysis by cell-oforigin, Epstein-Barr virus infection and survival |
| title_full_unstemmed | Diffuse large B-cell lymphoma in a South African cohort with a high HIV prevalence: an analysis by cell-oforigin, Epstein-Barr virus infection and survival |
| title_short | Diffuse large B-cell lymphoma in a South African cohort with a high HIV prevalence: an analysis by cell-oforigin, Epstein-Barr virus infection and survival |
| title_sort | diffuse large b cell lymphoma in a south african cohort with a high hiv prevalence an analysis by cell oforigin epstein barr virus infection and survival |
| topic | B-cell lymphoma DLBCL NOS HIV-infected HIV South Africa |
| url | http://hdl.handle.net/11427/36418 |
| work_keys_str_mv | AT cassimsumaiya diffuselargebcelllymphomainasouthafricancohortwithahighhivprevalenceananalysisbycelloforiginepsteinbarrvirusinfectionandsurvival |