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A multicenter retrospective cohort study analyzed 167 PTCL patients to quantify EBER-associated effects on survival and treatment response. A LASSO-penalized Cox regression yielded a risk scoring system integrating EBER status and clinical variables. After 22.1 months median follow-up, EBER positivity aligned with older age, hypoalbuminemia, higher IPI, altered immune marker positivity, and inferior chemotherapy response. Independent adverse factors included Albumin\u003C40, Platelet-to-Monocyte Ratio≤300, Lactate Dehydrogenase>250, Age>70, and EBER positivity, stratifying patients into three distinct risk groups with significantly different overall survival.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/epstein-barr-virus-encoded-small-rna-incorporated-prognostic-model-enables-precision-risk-stratification-and-guides-treatment-decisions-in-peripheral-t-cell-lymphoma-a-multicenter-retrospective-cohort/430384/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/epstein-barr-virus-encoded-small-rna-incorporated-prognostic-model-enables-precision-risk-stratification-and-guides-treatment-decisions-in-peripheral-t-cell-lymphoma-a-multicenter-retrospective-cohort/430384.png","ImageObject",300,407,{"name":92,"@type":93},"Margaret","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is EBER status considered important in peripheral T-cell lymphoma?","Question",{"text":113,"@type":114},"EBER reflects EBV infection and is associated with poor outcomes in PTCL. The study highlights that EBER positivity correlates with worse survival and poorer first-line chemotherapy response.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was the prognostic risk scoring system developed?",{"text":118,"@type":114},"A LASSO-penalized Cox regression model was used to build a prognostic score that incorporates EBER status and multiple clinical indicators.",{"name":120,"@type":111,"acceptedAnswer":121},"Which factors were identified as independent adverse prognostic variables?",{"text":122,"@type":114},"Albumin\u003C40, Platelet-to-Monocyte Ratio≤300, Lactate Dehydrogenase>250, Age>70, and EBER positivity were independently associated with poorer prognosis.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},430384,1790813130,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},137451207643,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Annals of Hematology (2025) 104:6275–6284  \n[https://doi.org/10.1007/s00277-025-06683-6](https://doi.org/10.1007/s00277-025-06683-6)  \nRESEARCH  \nEpstein-barr virus-encoded small RNA incorporated prognostic model enables precision risk stratification and guides treatment decisions in peripheral t-cell lymphoma: a multicenter retrospective cohort  \nZe-Tao Chen1 · Ling Huang2 · Han-Guo Guo2 · Cai-Di Lin2 · Xin-Miao Jiang2 · Xiao-Juan Wei2 · Fei-Li Chen2 ·  \nSi-Chu Liu2 · Hong Zhang2 · Zhan-Li Liang2 · Ning Wang2 · Xiao-Dan Zhang1 · Li-E. LIN3 · Ting-Bo Liu4 · Ji-Hao Zhou5 · Zhi-Gang Peng6 · Wen-Yu Li1,2  \nReceived: 24 August 2025 / Accepted: 1 October 2025 / Published online: 12 November 2025 © The Author(s) 2025  \nAbstract  \nEpstein-Barr virus-encoded small RNA (EBER), a hallmark of EBV infection, is a poor prognostic factor in peripheral T-cell lymphoma (PTCL) . Current clinical-based prognostic scores inadequately identify high-risk EBER-positive patients or guide therapy, underscoring the need for improved risk-stratification and treatment strategies. This multicenter cohort study, encompassing 167 PTCL patients, systematically analyzed the impact of EBER status on patient survival and treatment response. Utilizing LASSO-penalized Cox regression, a novel prognostic risk scoring system was developed incorporating EBER status and clinical indicators. With a median follow-up of 22.1 months, 63 patients (38%) died. The objective response rate was 57% . EBER-positive status was associated with older age, hypoalbuminemia, high IPI scores, shorter median overall survival (mOS), higher positivity rates for CD30, CD4, BCL6, PD-1, and poorer response to first-line chemotherapy. Multivariate analysis identified independent adverse prognostic factors (p\u003C 0.05): Albumin\u003C 40, Platelet-to-Monocyte Ratio ≤ 300, Lactate Dehydrogenase> 250, Age > 70, and EBER-positivity. A prognostic model incorporating these factors stratified patients into three significantly distinct risk groups (p\u003C 0.001): Low-risk (n = 45; 3-year OS 87.6%, mOS not reached), Intermediate-risk (n = 60; 3-year OS 49.7%, mOS 32.8 months), High-risk (n = 62; 3-year OS 25.1%, mOS 14.3 months) . The model outperformed existing models and demonstrated excellent discrimination, stability, clinical utility across PTCL subgroups. This novel prognostic score, integrating subtype-specific marker and clinical features, provides a refined framework for precise PTCL risk stratification and treatment guidance.  \nKeywords Epstein-Barr virus-encoded small RNA (EBER) · PTCL · Chidamide · Chemotherapy · Prognostic model  \nZe-Tao Chen and Ling Huang should be considered joint first author.  \n􀀍 Wen-Yu Li[lwy80411@163.com](lwy80411@163.com)  \n1 Guangdong Provincial People’s Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China  \n2 Lymphoma Division, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China  \n3 Department of Hematology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Hainan Province, Haikou, China  \n4 Department of Hematology, Fujian Medical University Union Hospital, Fuzhou, China  \n5 Department of Hematology, Shenzhen People’s Hospital, Jinan University, Shenzhen, China  \n6 Department of Hematology, First Affiliated Hospital, Guangxi Medical University, Nanning, China  \nIntroduction  \nPeripheral T-cell lymphoma (PTCL) is a highly heterogeneous, aggressive group comprising 10%−15% of non-Hodgkin lymphomas. In Asia, angioimmunoblastic T-cell lymphoma (AITL) and PTCL-not otherwise specified (PTCL-NOS) are the second and third most common subtypes (21.6–24.7% and 20.1–20.8%, respectively) [13, 37]. Most patients exhibit poor responses to chemotherapy. Despite recent improvements with optimized regimens and novel agents (e.g., CD30 monoclonal antibodies, histone deacetylase inhibitors), the 5-year overall survival (OS) remains below 3","cbCairwmdpUv44yH","https://ap.wps.com/l/cbCairwmdpUv44yH","pdf",4095156,"English","# Abstract\n## Prognostic impact and study objective\n## Model construction and risk stratification\n## Clinical implications","[{\"question\":\"Why is EBER status considered important in peripheral T-cell lymphoma?\",\"answer\":\"EBER reflects EBV infection and is associated with poor outcomes in PTCL. The study highlights that EBER positivity correlates with worse survival and poorer first-line chemotherapy response.\"},{\"question\":\"How was the prognostic risk scoring system developed?\",\"answer\":\"A LASSO-penalized Cox regression model was used to build a prognostic score that incorporates EBER status and multiple clinical indicators.\"},{\"question\":\"Which factors were identified as independent adverse prognostic variables?\",\"answer\":\"Albumin\\u003c40, Platelet-to-Monocyte Ratio≤300, Lactate Dehydrogenase\\u003e250, Age\\u003e70, and EBER positivity were independently associated with poorer prognosis.\"}]","Epstein-barr virus-encoded small RNA incorporated prognostic model enables precision risk stratification and guides treatment decisions in peripheral t-cell lymphoma - a multicenter retrospective cohort | PDF",1790652672,25]