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Prognostic impact of immunohistochemical biomarkers in diffuse large B‐cell lymphoma in the rituximab era

2009; Wiley; Volume: 100; Issue: 10 Linguagem: Inglês

10.1111/j.1349-7006.2009.01268.x

1349-7006

Ritsuko Seki, Koichi Ohshima, Tomoaki Fujisaki, Naokuni Uike, Fumio Kawano, Hisashi Gondo, Shigeyoshi Makino, Tetsuya Eto, Yukiyoshi Moriuchi, Fumihiro Taguchi, Tomohiko Kamimura, Hiroyuki Tsuda, Ryosuke Ogawa, Kazuya Shimoda, Kiyoshi Yamashita, Keiko Suzuki, Hitoshi Suzushima, Kunihiro Tsukazaki, Masakazu Higuchi, Atae Utsunomiya, Masahiro Iwahashi, Yutaka Imamura, Kazuo Tamura, Junji Suzumiya, Minoru Yoshida, Yasunobu Abe, Tadashi Matsumoto, Takashi Okamura,

Viral-associated cancers and disorders

We evaluated the usefulness of prognostic markers in patients with diffuse large B‐cell lymphoma (DLBCL) treated with cyclophosphamide, vincristine, doxorubicin, and prednisolone (CHOP) ± rituximab (R‐CHOP) in Japan. We studied 730 patients with DLBCL; 451 received CHOP and 279 R‐CHOP. We analyzed biopsy samples immunohistochemically for markers of germinal center B cells (CD10, Bcl‐6), postgerminal center B cells (Multiple myeloma‐1), and apoptosis (Bcl‐2). The median follow‐up period for surviving patients was 56.4 months for the CHOP group and 25.2 months for the R‐CHOP group. DLBCL were categorized as germinal center B (GCB) subtype (352/730; 48.2%) or non‐GCB subtype (378/730; 51.8%). In the CHOP group, the high expression of CD10 ( P = 0.022) or Bcl‐6 ( P = 0.021), or GCB subtype ( P = 0.05) was associated with better overall survival, whereas the high expression of Bcl‐2 ( P = 0.001) or MUM1 ( P = 0.011), or non‐GCB subtype ( P = 0.05) was associated with worse overall survival. In the R‐CHOP group, however, these biomarkers except Bcl‐6 were not significant prognostic factors. The patients with non‐GCB subtype showed improved survival in the R‐CHOP group ( P = 0.756). The International Prognostic Index was a useful clinical marker of survival in the CHOP group ( P < 0.001) and also in the R‐CHOP group ( P < 0.001). Results of improved survival with rituximab addition indicate that the relevance of previously recognized prognostic factors should be re‐evaluated. ( Cancer Sci 2009; 100: 1842–1847)