Journal
HAEMATOLOGICA
Volume 107, Issue 8, Pages 1864-1879Publisher
FERRATA STORTI FOUNDATION
DOI: 10.3324/haematol.2021.280003
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Funding
- National Medical Research Council [CSAINV17nov016, WBS R-179-000-063-213]
- National Medical Research Council Open Fund Large Collaborative Grant
- NUSMed Post-Doctoral Fellowship (PDF) [NUHSRO/2019/036/PDF/09]
- National Research Foundation Singapore
- Singapore Ministry of Education under its Research Centers of Excellence initiative
- Singapore IYMPHoma translational study (SYMPHONY) [NMRC OFLCG18May-0028]
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Primary EBV-positive nodal T/NK-cell lymphoma is a distinct entity characterized by low genomic instability, upregulation of immune pathways, and downregulation of EBV miRNA expression.
Primary Epstein-Barr virus (EBV)-positive nodal T/NK-cell lymphoma (PTCL-EBV) is a poorly understood disease which shows features resembling extranodal NK/T-cell lymphoma (ENKTL) and is currently not recognized as a distinct entity but categorized as a variant of primary T-cell lymphoma not otherwise specified (PTCL-NOS). Herein, we analyzed copynumber aberrations (n=77) with a focus on global measures of genomic instability and homologous recombination deficiency and performed gene expression (n=84) and EBV miRNA expression (n=24) profiling as well as targeted mutational analysis (n=16) to further characterize PTCL-EBV in relation to ENKTL and PTCL-NOS. Multivariate analysis revealed that patients with PTCL-EBV had a significantly worse outcome compared to patients with PTCL-NOS (P=0.002) but not to those with ENKTL. Remarkably, PTCL-EBV exhibited significantly lower genomic instability and homologous recombination deficiency scores compared to ENKTL and PTCL-NOS. Gene set enrichment analysis revealed that many immune-related pathways, interferon alpha/gamma response, and IL6_JAK_STAT3 signaling were significantly upregulated in PTCLEBV and correlated with lower genomic instability scores. We also identified that NF kappa B-associated genes, BIRC3, NFKB1 (P50) and CD27, and their proteins are upregulated in PTCL-EBV. Most PTCL-EBV demonstrated a type 2 EBV latency pattern and, strikingly, exhibited downregulated expression of most EBV miRNA compared to ENKTL and their target genes were also enriched in immune-related pathways. PTCL-EBV also showed frequent mutations of TET2, PIK3CD and STAT3, and are characterized by microsatellite stability. Overall, poor outcome, low genomic instability, upregulation of immune pathways and downregulation of EBV miRNA are distinctive features of PTCL-EBV. Our data support the concept that PTCL-EBV could be considered as a distinct entity, provide novel insights into the pathogenesis of the disease and offer potential new therapeutic targets for this tumor.
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