Biologic predictors in follicular lymphoma: importance of markers of immune response.
We sought to identify biologic indicators of prognosis in a series of 94 follicular lymphoma (FL) patients, focusing on markers of the host immune response as well as of B-cell maturation. Immune response was assessed with immunostains for CD68 (for lymphoma-associated macrophages, LAMs) and FOXP3 (regulatory T-cells). Lymphoma cells were evaluated for expression of bcl-2, CD10, and MUM-1. Clinical data were obtained for FLIPI, presence of bulky disease, presence of B-symptoms, treatment, and overall survival (OS). For the 69 initially treated patients, extrafollicular CD68+ cells (ef-CD68) and follicular FOXP3+ cells (f-FOXP3) were associated with shorter OS, while receipt of rituximab was associated with longer OS. Multivariable analysis showed ef-CD68 was the only independent factor associated with shorter OS. In subset analysis, ef-CD68 remained statistically significant in rituximab-naïve but not rituximab-treated patients. We confirm the importance of LAMs and f-FOXP3 as predictors of OS in FL.
Kelley
Todd
T
Department of Clinical Pathology, Cleveland Clinic, Taussig Cancer Center, Cleveland, OH, USA.
Beck
Rose
R
Absi
Ahmed
A
Jin
Tao
T
Pohlman
Brad
B
Hsi
Eric
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D015703:Antigens, CD / Q000032:analysis; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis; D015415:Biomarkers; D005260:Female; D051858:Forkhead Transcription Factors / Q000032:analysis; D006801:Humans; D050835:Interferon Regulatory Factors / Q000032:analysis; D008224:Lymphoma, Follicular / Q000175:diagnosis / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D008264:Macrophages / Q000502:physiology; D008297:Male; D008875:Middle Aged; D015260:Neprilysin / Q000032:analysis; D016016:Proportional Hazards Models; D000069283:Rituximab; D000099218:Interferon Regulatory Factor-4; D000097382:CD68 Molecule
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D015415:Biomarkers; D051858:Forkhead Transcription Factors; D050835:Interferon Regulatory Factors; D015260:Neprilysin; D000069283:Rituximab; D000099218:Interferon Regulatory Factor-4; C067980:CD68 antigen, human; D000097382:CD68 Molecule; C418974:FOXP3 protein, human