UICC World Cancer Congress 2006

Objective: The etiopathogenesis of Hodgkin's lymphoma (HL) is still the subject of investigation. Its association with Epstein Barr virus (EBV) has been shown in a large subset of childhood. The prevalence and significance of EBV detection in childhood HL is not known in North India.

Methods:145 children diagnosed with HL from 1991 to 2003 were studied for EBV status. Paraffin-embedded lymph node biopsies were stained by immunohistochemistry (IHC) with primary monoclonal antibodies against CD45, CD20, CD45RO, CD15, CD30, and EBV latent membrane protein-1 (LMP1). EBV encoded RNAs (EBERs) were detected by in situ hybridization (ISH). Twenty-five sex and age-matched controls with reactive lymphoid hyperplasia were also investigated for EBV-LMP1 and the EBERs.

Results: Of 145 cases of HL, mixed cellularity subtype (MC) was seen in 72.4%, nodular sclerosis in 22.8 %, nodular lymphocyte predominance in 1.4%, lymphocyte depletion and lymphocyte rich classical HL in 0.7% each, while 2.5% could not be classified. EBV-LMP1 expression was seen in 131 cases (90.3%), and in none of the 25 controls studied. The EBERs were detected in 136 cases, and in none of the 25 controls examined. 96.6% of the tumors were EBV positive with IHC and ISH combined. There was a statistically significant association between EBV positivity and age less than 10 years (p=0.005), and between EBV and lower socio-economic level (p=0.02). Stage of the disease, response to chemotherapy and survival were not related to EBV status. There was a significant poorer outcome in CD15 negative cases of classical HL (p=0.007).