Immunophenotype as prognostic factor for diffuse large B-cell lymphoma in patients undergoing clinical risk-adapted therapy
| Autor: | Jürgen Finke, Annette Schmitt-Graeff, Hendrik Veelken, J Schulte Moenting, S Vik Dannheim, Uwe M. Martens |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty Lymphoma B-Cell Time Factors medicine.medical_treatment Hematopoietic stem cell transplantation Disease-Free Survival Immunophenotyping International Prognostic Index hemic and lymphatic diseases Internal medicine medicine Biomarkers Tumor Humans Progression-free survival Aged Retrospective Studies Aged 80 and over business.industry Germinal center Hematology HLA-DR Antigens Middle Aged medicine.disease Germinal Center Prognosis Chemotherapy regimen Immunohistochemistry Survival Analysis Lymphoma Neoplasm Proteins Transplantation Treatment Outcome Proto-Oncogene Proteins c-bcl-2 Cancer research Proto-Oncogene Proteins c-bcl-6 Female Neprilysin Lymphoma Large B-Cell Diffuse business Diffuse large B-cell lymphoma Algorithms Follow-Up Studies |
| Zdroj: | Annals of oncology : official journal of the European Society for Medical Oncology. 18(5) |
| ISSN: | 0923-7534 |
| Popis: | Background: For patients with diffuse large B-cell lymphoma (DLBCL), the International Prognostic Index (IPI) predicts the likelihood for cure with chemotherapy. Biological parameters, including expression of Bcl-6, Bcl-2, CD10, major histocompatibility complex class II, and categorization as germinal center (GC) type have been described as IPI-independent prognostic factors. Patients and methods: Biological parameters were evaluated retrospectively by immunohistochemistry in 60 consecutive DLBCL patients of the prerituximab era. Forty-one of 60 patients underwent a risk-adapted treatment strategy including autologous stem-cell transplantation for high-risk patients (age-adjusted IPI = 2–3; slow response to chemotherapy). Results:Bcl-6 expression was associated with superior overall survival (OS) independently of the IPI. Inferior progression-free survival (PFS) was independently correlated with high expression of Bcl-2 and low positivity for HLA-DR and CD10. Distinction into GC and non-GC DLBCL on the basis of Bcl-6, CD10, and IRF-4 expression had no independent prognostic value. Within the risk-adapted treatment strategy, only HLA-DR retained a prognostic impact on OS (P = 0.0058) and PFS (P = 0.0002). Conclusions: In 60 patients with DLBCL treated with risk-adapted therapy, immunohistochemical subcategorization of DLBCL into GC and non-GC type has little clinical value. The IPI-associated risk appears to be mitigated by intensified upfront therapy. Low HLA-DR expression is associated with poor outcome after intensified upfront therapy. Therefore, additional treatment modalities appear to be required. |
| Databáze: | OpenAIRE |
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