Correlations between BCL6 rearrangement and outcome in patients with diffuse large B-cell lymphoma treated with CHOP or R-CHOP
Autor: | Guangming Han, Pedro Farinha, Joseph M. Connors, Nathalie A. Johnson, Christian Steidl, Jesse Shustik, Susana Ben Neriah, Randy D. Gascoyne, Laurie H. Sehn, Douglas E. Horsman |
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Rok vydání: | 2009 |
Předmět: |
Adult
Male Oncology medicine.medical_specialty Adolescent CHOP Immunophenotyping Cohort Studies Antibodies Monoclonal Murine-Derived Young Adult International Prognostic Index immune system diseases hemic and lymphatic diseases Internal medicine Antineoplastic Combined Chemotherapy Protocols Biomarkers Tumor medicine Humans Gene Rearrangement B-Lymphocyte Cyclophosphamide Aged Retrospective Studies Aged 80 and over BCL6 Gene Rearrangement business.industry Hematology Gene rearrangement Middle Aged medicine.disease BCL6 Lymphoma DNA-Binding Proteins Survival Rate Treatment Outcome Doxorubicin Vincristine Proto-Oncogene Proteins c-bcl-6 Cancer research Prednisone Female Original Article Rituximab Lymphoma Large B-Cell Diffuse business Diffuse large B-cell lymphoma Follow-Up Studies medicine.drug |
Zdroj: | PubMed Central |
ISSN: | 1592-8721 0390-6078 |
Popis: | Background BCL6 gene rearrangement is the most frequent chromosomal abnormality in diffuse large B-cell lymphoma, a malignancy characterized by genetic heterogeneity and wide variability in clinical outcome. The prognostic significance of BCL6 rearrangement has not been evaluated in the context of rituximab therapy for diffuse large B-cell lymphoma. We analyzed the effect of the BCL6 rearrangement on survival in patients with diffuse large B-cell lymphoma treated with CHOP and CHOP plus rituximab (R-CHOP). Design and Methods BCL6 rearrangement status was analyzed by fluorescence in situ hybridization with break-apart probes in 164 patients with diffuse large B-cell lymphoma treated with CHOP (n=65) or R-CHOP (n=99). Cell-of-origin immunophenotype including BCL6 protein expression were determined by immunohistochemistry on a tissue microarray. Results BCL6 rearrangement was detected in 19.5% of cases. The presence of the gene rearrangement was associated with a non-germinal center B-cell immunophenotype ( P =0.006), and showed no correlation with BCL6 protein expression. A trend toward inferior overall survival was observed in association with the BCL6 rearrangement among patients treated with R-CHOP ( P =0.08), but not among patients treated with CHOP ( P =0.64). However, BCL6 rearrangement also correlated with a high International Prognostic Index score ( P =0.02), and did not demonstrate independent prognostic value by multivariate analysis. Conclusions The introduction of rituximab may have altered the prognostic impact of BCL6 gene rearrangement in patients with diffuse large B-cell lymphoma. However, prospective analysis within large randomized clinical trials will be needed to clarify the prognostic significance of this biomarker in the rituximab era. |
Databáze: | OpenAIRE |
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