title: Prognostic implications of BCL6 rearrangement in uniformly treated patients with diffuse large B-cell lymphoma--a Nordic Lymphoma Group study.
abstract: The purpose of this study was to investigate the prognostic implications of BCL6 rearrangement in a uniformly treated population of patients with diffuse large B-cell lymphoma (DLBCL) and to characterise the relationship between BCL6 rearrangement and prognostic factors. A total of 269 patients with DLBCL entered a randomised trial comparing the chemotherapy regimen CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) to the MACOP-B (methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, bleomycin) regimen. In 44 cases, frozen tissue was available for assessment of BCL6 status by Southern blot analysis. BCL6 was rearranged in six of 43 evaluable cases (14%), and was associated with elevated lactate dehydrogenase (LDH), and a higher patient age. No association between BCL6 status and expression of BCL2, Ki-67 or TP53 was found. Patients presenting with BCL6 rearrangement displayed a weak trend towards better overall and failure-free survival (67 and 67% at 5 years), compared to patients with germline BCL6 (63 and 52%), but the difference was not statistically significant. In accordance with previously published series, the presence of BCL6 rearrangement does not define a prognostically distinct subgroup of DLBCL. Assessment of BCL6 status may, however, be of clinical interest when related to other prognostic variables.
authors.affiliation: Department of Oncology, Lund University Hospital, SE-221 85 Lund, Sweden. mats.jerkeman@onk.lu.se
authors.forename: M
authors.initials: M
authors.lastname: Jerkeman
authors.forename: P
authors.initials: P
authors.lastname: Aman
authors.forename: E
authors.initials: E
authors.lastname: Cavallin-Stahl
authors.forename: E
authors.initials: E
authors.lastname: Torlakovic
authors.forename: M
authors.initials: M
authors.lastname: Akerman
authors.forename: F
authors.initials: F
authors.lastname: Mitelman
authors.forename: T
authors.initials: T
authors.lastname: Fioretos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000627:therapeutic use; D015139:Blotting, Southern; D003520:Cyclophosphamide / Q000627:therapeutic use; D004273:DNA, Neoplasm / Q000032:analysis / Q000378:metabolism; D004268:DNA-Binding Proteins / Q000235:genetics*; D004317:Doxorubicin / Q000627:therapeutic use; D015322:Gene Rearrangement, B-Lymphocyte / Q000235:genetics*; D006801:Humans; D016130:Immunophenotyping; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D002955:Leucovorin / Q000627:therapeutic use; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000235:genetics*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000235:genetics*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009367:Neoplasm Staging; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D011518:Proto-Oncogene Proteins / Q000235:genetics*; D051560:Proto-Oncogene Proteins c-bcl-6; D014157:Transcription Factors / Q000235:genetics*; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D004273:DNA, Neoplasm; D004268:DNA-Binding Proteins; D011518:Proto-Oncogene Proteins; D051560:Proto-Oncogene Proteins c-bcl-6; D014157:Transcription Factors; D001761:Bleomycin; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D007770:L-Lactate Dehydrogenase; D002955:Leucovorin; D011241:Prednisone; D008727:Methotrexate