{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T07:43:13Z","timestamp":1792222993744,"version":"4.4.0"},"reference-count":44,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC 113\u20102320\u2010B\u2010006\u2010044\u2010MY3"],"award-info":[{"award-number":["NSTC 113\u20102320\u2010B\u2010006\u2010044\u2010MY3"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004844","name":"National Cheng Kung University Hospital","doi-asserted-by":"publisher","award":["NCKUH\u201011504036"],"award-info":[{"award-number":["NCKUH\u201011504036"]}],"id":[{"id":"10.13039\/501100004844","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013227","name":"Health Promotion Administration, Ministry of Health and Welfare","doi-asserted-by":"publisher","award":["A1131112"],"award-info":[{"award-number":["A1131112"]}],"id":[{"id":"10.13039\/100013227","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Hodgkin lymphoma (HL) is associated with Epstein\u2013Barr virus (EBV) infection in a subset of cases. We previously showed that the incidence of HL in Taiwan increased ~2.5\u2010fold between 2001 and 2020, particularly among young women with the nodular sclerosis (NS) subtype. In this nationwide multicenter study, we evaluated EBV status in HL to determine its impact on clinicopathologic features and survival outcomes. We found that the proportion of EBV\u2010associated HL in Taiwan declined over the past two decades, from 39% to 27%. EBV\u2010positive frequency exhibited a bimodal age distribution, peaking in children &lt;\u200910\u2009years (63%) and adults &gt;\u200970\u2009years (80%), with the lowest frequency in patients 20\u201329\u2009years (11%). Compared with EBV\u2010negative patients, EBV\u2010positive patients were older (53.5 vs. 32.9\u2009years;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), predominantly male (73.1% vs. 48.7%;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), more likely to have nodal disease (83.3% vs. 74.2%;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.003) and mixed cellularity histology (37.1% vs. 11.4%;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), and had inferior 10\u2010year survival (56.3% vs. 85.7%;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Adverse prognostic factors in HL included older age (&gt;\u200960\u2009years), B symptoms, non\u2010NS histology, EBV\u2010positivity, advanced\u2010stage disease (Stage III\u2013IV), and a high International Prognostic Score (IPS, 4\u20137). On multivariate analysis, older age and a high IPS retained prognostic significance. Large registry datasets from Taiwan and the US further demonstrated that survival outcomes have improved over the past two decades. Female patients and those with the NS and nodular lymphocyte\u2010predominant subtypes had significantly better survival. These findings provide insight into the biological impact of EBV in HL and help inform strategies for disease prevention and management.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70780","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T07:31:42Z","timestamp":1792222302000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epstein\u2013Barr Virus Association and Prognosis in Taiwanese Hodgkin Lymphoma: A Nationwide Multicenter Study With Comparison to United States Whites"],"prefix":"10.1002","author":[{"given":"Shu\u2010Hsien","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Pathology National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang\u2010Tsu","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department and Graduate Institute of Pathology National Taiwan University Hospital, College of Medicine, National Taiwan University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010Ju","family":"Chiang","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Preventive Medicine, College of Public Health National Taiwan University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u2010Ching","family":"Wang","sequence":"additional","affiliation":[{"name":"Department\u00a0of Pathology China Medical University Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3171-7672","authenticated-orcid":false,"given":"Wen\u2010Chung","family":"Lee","sequence":"additional","affiliation":[{"name":"Taiwan Cancer Registry  Taipei Taiwan"},{"name":"Institute of Health Data Analytics and Statistics, College of Public Health National Taiwan University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsin\u2010Ni","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Taichung Veterans General Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheau\u2010Fang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pathology Kaohsiung Medical University Hospital  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo\u2010Jung","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology Shuang Ho Hospital, Taipei Medical University  New Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen\u2010Lin","family":"Huang","sequence":"additional","affiliation":[{"name":"Institute of Stem Cell and Translational Cancer Research and Department of Anatomic Pathology Chang Gung Memorial Hospital at Linkou and Chang Gung University  Linkou Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Jen","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Pathology Tri\u2010Service General Hospital, National Defense Medical Center  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching\u2010Fen","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Taipei Veterans General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie\u2010Yang","family":"Jhuang","sequence":"additional","affiliation":[{"name":"Department of Pathology Mackay Memorial Hospital, Tamsui Branch  New Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan\u2010Ru","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Pathology Chung Shan Medical University Hospital  New Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen\u2010Chang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation  Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Jeffery","family":"Medeiros","sequence":"additional","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9665-5236","authenticated-orcid":false,"given":"Kung\u2010Chao","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Pathology National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University  Tainan Taiwan"},{"name":"Center for Cancer Research Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,17]]},"reference":[{"issue":"7","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.1038\/s41375-022-01620-2","article-title":"The 5th Edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms","volume":"36","author":"Alaggio R.","year":"2022","journal-title":"Leukemia"},{"issue":"12","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"2407","DOI":"10.1038\/s41379-020-0575-3","article-title":"Frequent Traces of EBV Infection in Hodgkin and Non\u2010Hodgkin Lymphomas Classified as EBV\u2010Negative by Routine Methods: Expanding the Landscape of EBV\u2010Related Lymphomas","volume":"33","author":"Mundo L.","year":"2020","journal-title":"Modern Pathology"},{"issue":"1","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.pathol.2019.09.005","article-title":"Hodgkin Lymphoma: A Review of Pathological Features and Recent Advances in Pathogenesis","volume":"52","author":"Piris M. 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