Epstein-Barr virus infection is associated with clinical characteristics and poor prognosis of multiple myeloma

Biosci Rep. 2019 Oct 30;39(10):BSR20190284. doi: 10.1042/BSR20190284.

Abstract

The aim of the present study was to evaluate the relationship of Epstein-Barr virus (EBV) infection and multiple myeloma (MM) and its impact on clinical characteristics and prognosis. Fresh peripheral blood mononuclear cells (PBMCs) from 139 MM patients who had been diagnosed and treated from January 2010 to May 2018 and 50 PBMC samples from healthy donors were obtained. PCR was carried out for detection of EBV-DNA. The results indicated a significantly higher EBV-DNA concentration among 139 MM patients compared with healthy controls (P<0.05). Correlation analysis showed that the expression of EBV-DNA was positively correlated with the serum free light chain ratio (sFLCR) and progressive disease (PD)/relapse (P<0.05). Especially, in EBV-DNA high-expression MM patients, EBV-DNA concentration for patients with sFLCR ≥100 was higher than that of patients with sFLCR <100. EBV-DNA concentration was higher in patients with disease PD/relapse than those without disease PD/relapse. In univariate analysis, the progress free survival (PFS) was inferior in MM patients with high expression of EBV-DNA, high lactate dehydrogenase (LDH), and high-risk according to mSMART and International Myeloma Working Group (IMWG), stage III according to R-ISS staging, extramedullary lesions, and genetic changes (P<0.05). However, in multivariate analysis, LDH, poor karyotype, R-ISS staging, and mSMART were independent prognostic factors for PFS. Taken together, our studies suggest that an association exists between EBV infection and clinical characteristics of MM patients, and EBV infection appears to have a slight impact on the prognosis of MM. However, the results require further validation in other independent prospective MM cohorts.

Keywords: Epstein-Barr virus; correlation analysis; multiple myeloma; prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bortezomib / administration & dosage
  • Bortezomib / therapeutic use*
  • Cells, Cultured
  • DNA, Viral / genetics
  • Epstein-Barr Virus Infections / complications
  • Epstein-Barr Virus Infections / virology
  • Female
  • Gene Expression Regulation, Viral
  • Herpesvirus 4, Human / genetics
  • Herpesvirus 4, Human / physiology
  • Humans
  • Kaplan-Meier Estimate
  • L-Lactate Dehydrogenase / metabolism
  • Leukocytes, Mononuclear / pathology
  • Leukocytes, Mononuclear / virology
  • Male
  • Middle Aged
  • Multiple Myeloma / complications
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / therapy*
  • Prognosis
  • Stem Cell Transplantation / methods*
  • Thalidomide / administration & dosage
  • Thalidomide / therapeutic use*
  • Transplantation, Autologous

Substances

  • DNA, Viral
  • Thalidomide
  • Bortezomib
  • L-Lactate Dehydrogenase