Adult Hodgkin's Disease and Epstein Barr Virus

描述（申请人提供）：霍奇金淋巴瘤治疗的成功经验 疾病（HD）强调化疗和放疗的长期后果 治疗这种疾病的方法。目前的组间试验 反映了无故障生存的改善，因为它支付增加 注意减少治疗对幸存者的晚期影响。的存在 EB病毒（EBV）在很大一部分HD肿瘤中提供了 有机会开发使用病毒特异性肿瘤标志物， 病毒特异性免疫疗法东部肿瘤协作组（ECOG） 和西南肿瘤组（SWOG）试验E2496提供了一个无与伦比的 有机会回答这些问题。通过对这一庞大群体的评估， 对患者，确定活检标本中是否检出EBV 确定了一个低风险群体（特别是45岁以上的患者） 年，应该是可以的。此外，组织效用的验证 在HD中检测EBV的阵列将允许这种发展， 重要和具有成本效益的资源。将进行仔细分析， 确定是否在组织阵列或血浆中进行EBV检测研究， 实时PCR的结果与检测研究的结果平行 应用于常规组织切片。与此同时， 血浆中病毒DNA清除率及不同处理的影响 将使用实时PCR进行该清除率的方案。率 将分析血浆中病毒DNA的清除率以及持久性， 确定它们是否预测耐药疾病或复发。的关系 血浆IL-10水平、IL-10启动子多态性和EBV状态之间的关系 将对肿瘤进行评估。最后，我们试图描述细胞毒性 T细胞对HD中表达的EBV抗原的应答（在对EBV抗原的应答的背景下） 其他EBV抗原和来自其他病毒的抗原），并评估 化疗/放疗对这些反应。这项工作应该奠定 为未来的病毒抗原靶向治疗奠定基础。

DESCRIPTION (PROVIDED BY APPLICANT): Successes in the treatment of Hodgkin's disease (HD) highlight the long-term consequences of chemotherapy and radiation therapy in the management of this disease. The current inter-group trial reflects the improvement in failure free survival as it pays increasing attention to reducing the late effects of therapy in survivors. The presence of Epstein-Barr virus (EBV) in a significant proportion of HD tumors offers the opportunity to develop the use of virus-specific tumor markers and virus-specific immune therapy. The Eastern Cooperative Oncology Group (ECOG) and Southwestern Oncology Group (SWOG) trial E2496 offers an unparalleled opportunity to address these questions. Through evaluation of this large group of patients, the determination of whether EBV detection in biopsy specimens identifies a poor risk group (particularly in patients over the age of 45 years) should be possible. In addition, the validation of the utility of tissue arrays in the detection of EBV in HD will allow the development of this important and cost-efficient resource. A careful analysis will be performed to determine whether EBV detection studies in tissue arrays or in plasma by real-time PCR yield results parallel to those achieved with detection studies applied to conventional tissue sections. In parallel, the determination of the rate of viral DNA clearance in plasma and the effect of different treatment regimens on this clearance will be performed using real-time PCR. The rate of clearance as well as the persistence of viral DNA in plasma will analyzed to determine if they predict resistant disease or relapse. The relationship between plasma IL-10 levels, IL-10 promoter polymorphisms, and the EBV status of the tumor will be evaluated. Finally, we seek to characterize the cytotoxic T-cell response to EBV antigens expressed in HD (in the context of response to other EBV antigens and antigens from other viruses) and to assess the impact of chemotherapy/radiotherapy on these responses. This work should lay the groundwork for future viral antigen targeted therapies.