AIDS-related B-cell lymphoma (ARL): correlation of prognosis with differentiation profiles assessed by immunophenotyping.
This study was undertaken to analyze the differentiation profiles assessed by immunophenotyping in AIDS-related B-cell lymphoma (ARL) and their relation to the clinical course. Paraffin-embedded sections of 89 ARL cases during 1989 to 2004 were stained immunohistochemically with antibodies to CD3, CD10, CD20, CD38, CD138/Syndecan-1 (Syn-1), multiple myeloma-1/interferon regulatory factor-4 (MUM1/IRF4), B-cell lymphoma protein-2 (BCL-2), BCL-6, latent membrane protein-1 (LMP-1), and Ki-67. Expression of CD10 and CD20 were associated with better overall survival (OS; P = .009 and P = .04, respectively). Expression of CD20 was associated with longer disease-free survival (DFS; P = .03), whereas expression of CD138/Syn-1 was associated with shorter DFS (P = .03). OS and DFS were worse in patients with immunophenotypic profiles related to post-germinal center (GC) differentiation (BCL-6 and CD10 negative, MUM1/IRF4 and/or CD138/Syn-1 positive) when compared with GC differentiation (P = .01). When controlled for age-adjusted International Prognostic Index (IPI), prior AIDS-defining illness (ADI), and year of ARL diagnosis, a post-GC differentiation remained significantly associated with poor OS and DFS. Expression of CD10 was associated with a preserved immunocompetence, whereas CD20 was less frequent in patients developing ARL while on highly active antiretroviral therapy (P = .04). In summary, lack of CD20 or CD10 expression and a post-germinal center signature are associated with a worse prognosis in ARL.
Hoffmann
Christian
C
Infectious Diseases Outpatient Clinic, II. Department of Medicine, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Chemnitzstrasse 33, 24116 Kiel, Germany. c.hoffmann@med2.uni-kiel.de
Tiemann
Markus
M
Schrader
Carsten
C
Janssen
Dirk
D
Wolf
Eva
E
Vierbuchen
Mathias
M
Parwaresch
Reza
R
Ernestus
Karen
K
Plettenberg
Andreas
A
Stoehr
Albrecht
A
Fatkenheuer
Gerd
G
Wyen
Christoph
C
Oette
Mark
M
Horst
Heinz-August
HA
D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000096:biosynthesis* / Q000276:immunology; D018951:Antigens, CD20 / Q000096:biosynthesis / Q000276:immunology; D000943:Antigens, Differentiation / Q000096:biosynthesis* / Q000276:immunology; D014408:Biomarkers, Tumor / Q000032:analysis; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D018858:Germinal Center / Q000276:immunology; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping / Q000379:methods*; D016483:Lymphoma, AIDS-Related / Q000175:diagnosis / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015260:Neprilysin / Q000096:biosynthesis / Q000276:immunology; D011379:Prognosis; D012044:Regression Analysis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors
D015703:Antigens, CD; D018951:Antigens, CD20; D000943:Antigens, Differentiation; D014408:Biomarkers, Tumor; D015260:Neprilysin