Intravascular large B-cell lymphoma (IVLBCL): a clinicopathologic study of 96 cases with special reference to the immunophenotypic heterogeneity of CD5.
Intravascular large B-cell lymphoma (IVLBCL) is pathologically distinct with a broad clinical spectrum and immunophenotypic heterogeneity. A series of 96 patients with IVLBCL (median age, 67 years; range, 41-85 years; 50 men) was reviewed. Anemia/thrombocytopenia (84%), hepatosplenomegaly (77%), B symptoms (76%), bone marrow involvement (75%), and hemophagocytosis (61%) were frequently observed. The International Prognostic Index score was high or high-intermediate in 92%. For 62 patients receiving anthracycline-based chemotherapies, median survival was 13 months. CD5, CD10, Bcl-6, MUM1, and Bcl-2 were positive in 38%, 13%, 26%, 95%, and 91% of tumors, respectively. All 59 CD10- IVLBCL cases examined were nongerminal center B-cell type because they lacked the Bcl-6+MUM1- immunophenotype. CD5 positivity was associated with a higher prevalence of marrow/blood involvement and thrombocytopenia and a lower frequency of neurologic abnormalities among patients with CD10-IVLBCL. Compared with 97 cases of de novo CD5+CD10-diffuse LBCL, 31 cases of CD5+CD10-IVLBCL exhibited higher frequencies of poor prognostic parameters, except age. Multivariate analysis in IVLBCL revealed that a lack of anthracycline-based chemotherapies (P<.001, hazard ratio [HR]: 9.256), age older than 60 years (P=.012, HR: 2.459), and thrombocytopenia less than 100x10(9)/L (P=.012, HR: 2.427) were independently unfavorable prognostic factors; CD5 positivity was not. Beyond immunophenotypic diversity, IVLBCL constitutes a unique group with aggressive behavior.
Murase
Takuhei
T
Department of Internal Medicine, Nishio Municipal Hospital, 6 Kami-awara, Kumamicho, Nishio, Aichi, and Department of Hematology, Mie University Graduate School of Medicine, Tsu, Japan. tmurase@va.starcat.ne.jp
Yamaguchi
Motoko
M
Suzuki
Ritsuro
R
Okamoto
Masataka
M
Sato
Yumiko
Y
Tamaru
Jun-ichi
J
Kojima
Masaru
M
Miura
Ikuo
I
Mori
Naoyoshi
N
Yoshino
Tadashi
T
Nakamura
Shigeo
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018956:CD5 Antigens / Q000032:analysis* / Q000235:genetics; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D016393:Lymphoma, B-Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D019043:Vascular Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*
D018956:CD5 Antigens