Ki67 and 4F2 antigen expression as well as DNA synthesis predict survival at relapse/tumour progression in low-grade B-cell lymphoma.
Previous work has shown that parameters of cell activation studied on lymphoma biopsies can be used to discriminate between low-grade and high-grade non-Hodgkin's lymphomas and to predict prognosis in the low-grade malignancy group alone. We have now examined expression of several activation antigens and indicators of DNA synthesis in 29 patients with low-grade malignant B-cell lymphomas at the time of primary diagnosis and later at relapse and/or tumour progression. At both times, the level of 4F2 antigen expression examined by flow cytometry on cells in suspension as well as the number of Ki67 antigen-positive cells examined by immunohistochemistry were predictive of patient survival. DNA synthesis estimated by (3H-TdR) thymidine incorporation was of prognostic value at the second biopsy only. These parameters were more sensitive than histological demonstration of morphological transformation in secondary high-grade lymphomas in identifying high-risk patients at repeated biopsy. We propose that Ki67 or 4F2 expression or a marker of DNA synthesis (such as 3H-TdR incorporation or labelling index) should be evaluated when repeated biopsies are performed, in order to select patients for whom aggressive chemotherapy may be considered.
Holte
H
H
Department of Pathology, Norwegian Radium Hospital, Oslo.
de Lange Davies
C
C
Beiske
K
K
Stokke
T
T
Marton
P F
PF
Smeland
E B
EB
Høie
J
J
Kvaløy
S
S
D000954:Antigens, Surface / Q000378:metabolism*; D001402:B-Lymphocytes; D001706:Biopsy; D002455:Cell Division; D004247:DNA / Q000096:biosynthesis; D005434:Flow Cytometry; D006801:Humans; D019394:Ki-67 Antigen; D008228:Lymphoma, Non-Hodgkin / Q000276:immunology / Q000378:metabolism*; D011003:Ploidies; D011379:Prognosis; D011990:Receptors, Transferrin / Q000378:metabolism
D000954:Antigens, Surface; D019394:Ki-67 Antigen; D011990:Receptors, Transferrin; D004247:DNA