Epstein - Barr virus-positive diffuse large B-cell lymphoma of the elderly: a concise review and update

Purpose of reviewEpstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) of the elderly is an EBV-positive monoclonal large B-cell proliferative disease that arises in elderly patients older than 50 years. Updated knowledge on geographical/ethnical variations in the prevalence and prognostic impact of EBV positivity, the genetic mechanisms of lymphomagenesis, and the validity of the disease is available.Recent findingsThe poor prognostic impact of EBV positivity is consistent among Asian populations, but not in Western populations. CD30 may be associated with this geographical/ethnical variation. Gene expression analyses have confirmed the enhanced activity of the NF-B and JAK/STAT pathways and more frequent expression of CD30 in EBV-positive DLBCL of the elderly. A substantial proportion of cases of EBV-positive DLBCL of the elderly occur in young immunocompetent adults; moreover, EBV-positive DLBCL in young adults has a distinct clinical course compared with EBV-positive DLBCL of the elderly.SummaryFurther research is anticipated, as follows: first, identifying geographical/ethnical differences in gene expression profiles and CD30 coexpression in EBV-positive DLBCL of the elderly; second, feasibility of the revision of the current disease entity confined to elderly patients; and third, novel therapeutic approaches targeting CD30 and the NF-B and JAK/STAT pathways in EBV-positive DLBCL of the elderly.