A population-based study of cellular markers in R-CHOP treated diffuse large B-cell lymphoma patients

AIM: To determine the prognostic significance of co-expression of MYC, BCL-2 and BCL-6 proteins in combination with other biomarkers and clinical characteristics within a population-based cohort of diffuse large B-cell lymphoma (DLBCL) patients uniformly treated with R-CHOP.

PATIENTS AND METHODS: The immunohistochemical (IHC) expression of CD10, BCL-2, BCL-6, MUM1, MYC, CD5, CD30, Ki-67 and p53 was evaluated in a retrospective, population-based study comprising 188 DLBCL patients treated with R-CHOP and diagnosed in Sweden between 2002 and 2012.

RESULTS: Patients had a median age at diagnosis of 64 years (26-85 years) with a male:female ratio of 1.4:1. Approximately half (52%) of the patients presented with an International Prognostic Index (IPI) age adjusted (IPIaa) ≥ 2. Median follow-up time was 51 months (range 0.4-158) and the five-year lymphoma-specific survival (LSS) was 76%, five-year overall survival (OS) was 65% and five-year progression-free survival (PFS) was 61%. A high Ki-67 value was found in 59% of patients, while p53 overexpression was detected in 12% of patients and MYC, BCL-2 and BCL-6 expression were detected in 42%, 55% and 74% of patients, respectively. IPIaa ≥2 (p = 0.002), Ki-67 ≥ 70% (p = 0.04) and p53 overexpression ≥50% (p = 0.02) were associated with inferior LSS and OS. Co-expression of both MYC (>40%) and BCL-2 (>70%) proteins was detected in 27% of patients and correlated with a significantly inferior LSS (p = 0.0002), OS (p = 0.009) and PFS (p = 0.03). In addition, triple expression of MYC, BCL-2 and BCL-6, also correlated with a significantly inferior LSS (p = 0.02).

CONCLUSION: Concurrent expression of MYC and BCL-2 proteins, as detected by IHC, was strongly associated with an inferior survival in DLBCL patients treated with R-CHOP. Other markers affecting survival were triple expression of MYC, BCL-2 and BCL-6, IPIaa, high Ki-67 and p53 overexpression.

Medienart:

E-Artikel

Erscheinungsjahr:

2016

Erschienen:

2016

Enthalten in:

Zur Gesamtaufnahme - volume:55

Enthalten in:

Acta oncologica (Stockholm, Sweden) - 55(2016), 9-10 vom: 23. Sept., Seite 1126-1131

Sprache:

Englisch

Beteiligte Personen:

Abdulla, Maysaa [VerfasserIn]
Laszlo, Sofia [VerfasserIn]
Triumf, Johanna [VerfasserIn]
Hedström, Gustaf [VerfasserIn]
Berglund, Mattias [VerfasserIn]
Enblad, Gunilla [VerfasserIn]
Amini, Rose-Marie [VerfasserIn]

Links:

Volltext

Themen:

4F4X42SYQ6
5J49Q6B70F
80168379AG
8N3DW7272P
Antibodies, Monoclonal, Murine-Derived
BCL2 protein, human
BCL6 protein, human
Biomarkers, Tumor
Cyclophosphamide
Doxorubicin
Journal Article
Ki-67 Antigen
MYC protein, human
Prednisone
Proto-Oncogene Proteins c-bcl-2
Proto-Oncogene Proteins c-bcl-6
Proto-Oncogene Proteins c-myc
R-CHOP protocol
Rituximab
TP53 protein, human
Tumor Suppressor Protein p53
VB0R961HZT
Vincristine

Anmerkungen:

Date Completed 30.01.2018

Date Revised 10.12.2019

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1080/0284186X.2016.1189093

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM263654532