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An Efficient and Simple Method to Establish NK and T Cell Lines from Patients with Chronic Active Epstein-Barr Virus Infection

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Published on: March 30, 2018

Epstein-Barr virus-associated natural killer/T-cell lymphomas.

Naoko Asano¹, Seiichi Kato, Shigeo Nakamura

¹Department of Clinical Laboratories, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan. naasano@med.nagoya-u.ac.jp

Best Practice & Research. Clinical Haematology

|June 18, 2013

Summary

Epstein-Barr virus (EBV)-associated lymphomas, common in Asia and South America, often affect extranodal sites. While radiotherapy helps extranodal NK/T-cell lymphoma (ENKL), chemotherapy resistance is a challenge, though l-asparaginase regimens show promise.

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Area of Science:

Hematology
Oncology
Virology

Background:

Epstein-Barr virus (EBV)-associated natural killer (NK)/T-cell lymphomas are geographically prevalent in Asian and South American populations.
These lymphomas typically manifest in extranodal sites, such as the nasal or paranasal areas, with less frequent nodal involvement.
Tumor cells characteristically display a cytotoxic phenotype, marked by granzyme B and perforin expression, and EBV presence is confirmed by EBER in situ hybridization.

Purpose of the Study:

To describe two distinct EBV-associated T-cell lymphomas: extranodal NK/T-cell lymphoma, nasal type (ENKL) and nodal cytotoxic molecule-positive EBV-positive peripheral T-cell lymphoma, not specified type (CM + EBV + PTCL-N).
To highlight the therapeutic challenges and potential treatment strategies for these lymphomas.

Main Methods:

Review and characterization of ENKL as a representative extranodal EBV-associated NK/T-cell lymphoma.
Review and characterization of nodal CM + EBV + PTCL-N as a representative nodal lymphoma.
Analysis of treatment responses and resistance mechanisms, including P-glycoprotein expression and multidrug resistance (MDR1) gene involvement.

Main Results:

Both ENKL and nodal CM + EBV + PTCL-N demonstrate resistance to standard chemotherapy.
ENKL shows sensitivity to radiotherapy but exhibits reduced response to conventional chemotherapeutics due to P-glycoprotein expression.
l-asparaginase-containing regimens, such as SMILE, have demonstrated efficacy in treating ENKL.

Conclusions:

EBV-associated lymphomas present unique clinical and therapeutic challenges.
P-glycoprotein expression contributes to chemotherapy refractoriness in ENKL.
Further evaluation of effective chemotherapy for nodal CM + EBV + PTCL-N is warranted, while l-asparaginase-based regimens offer a promising avenue for ENKL treatment.