Bcl-2 protein expression is the strongest independent prognostic factor of survival in primary cutaneous large B-cell lymphomas.
Bcl-2 protein expression has been associated with poor prognosis in patients with noncutaneous diffuse large B-cell lymphomas. In primary cutaneous large B-cell lymphomas, the location on the leg, the round-cell morphology defined as the predominance of centroblasts and immunoblasts over large centrocytes, and multiple skin lesions were identified as adverse prognostic factors. The prognostic value of bcl-2 protein expression has not been studied in large series of patients. We evaluated 80 primary cutaneous large B-cell lymphomas collected by the French Study Group on Cutaneous Lymphomas. The prognostic value of age, sex, number of lesions, cutaneous extent, location, serum lactate dehydrogenase (LDH) level, B symptoms, morphology, and bcl-2 protein expression was studied. The overall 5-year specific survival rate was 65%. In univariate analysis, advanced age, multiple skin lesions (n = 48), location on the leg (n = 25), round-cell morphology (n = 32), and bcl-2 expression (n = 39) were significantly related to death from lymphoma. In multivariate analysis, bcl-2 expression (P =.0003), multiple skin lesions (P =.004), and age remained independent prognostic factors. The 5-year specific survival rates in bcl-2-positive and bcl-2-negative patients were 41% and 89%, respectively (P <.0001). A new prognostic classification of primary cutaneous B-cell lymphoma should be based primarily on bcl-2 protein expression rather than the location of skin lesions.
Grange
Florent
F
Department of Dermatology, Hôpital Pasteur, Colmar Cedex, France. florent.grange@ch-colmar.rss.fr
Petrella
Tony
T
Beylot-Barry
Marie
M
Joly
Pascal
P
D'Incan
Michel
M
Delaunay
Michele
M
Machet
Laurent
L
Avril
Marie-Francoise
MF
Dalac
Sophie
S
Bernard
Philippe
P
Carlotti
Agnes
A
Esteve
Eric
E
Vergier
Beatrice
B
Dechelotte
Pierre
P
Cassagnau
Elisabeth
E
Courville
Philippe
P
Saiag
Philippe
P
Laroche
Liliane
L
Bagot
Martine
M
Wechsler
Janine
J
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D048429:Cell Size; D005260:Female; D006801:Humans; D007866:Leg; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis*; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012878:Skin Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D016019:Survival Analysis; D015996:Survival Rate
D009363:Neoplasm Proteins; D019253:Proto-Oncogene Proteins c-bcl-2