Clinicopathologic characteristics and treatment outcome of the addition of rituximab to chemotherapy for CD5-positive in comparison with CD5-negative diffuse large B-cell lymphoma.
BACKGROUND
CD5-positive (CD5+) diffuse large B-cell lymphoma (DLBCL) comprises ∼10% of DLBCLs, and it is associated with poor prognosis. The clinicopathologic characteristics and prognosis of CD5-negative (CD5-) DLBCL and CD5+ DLBCL were compared.


METHODS
The subjects were 607 DLBCL patients in whom cell surface markers could be analyzed, among 930 consecutive patients registered in the Adult Lymphoma Treatment Study Group between 1998 and 2008.


RESULTS
In all, 102 patients (16.8%) had CD5+ DLBCL. Compared with CD5- DLBCL, CD5+ DLBCL was more closely associated with elevated serum lactate dehydrogenase level, advanced stage, poor performance status, extranodal sites, CD10-, BCL-2+, MUM1+, and nongerminal center B-cell type. The 5-year overall survival (OS) rates of CD5+ DLBCL (n = 102) and CD5- DLBCL (n = 505) were 55% and 65%, respectively (P = 0.032), with 5-year progression-free survival (PFS) rates of 52% and 61%, respectively (P = 0.041). In the CD5+ DLBCL patients, the addition of rituximab to chemotherapy significantly improved PFS (4-year PFS, 47.4% versus 62.5%), but not OS (4-year OS, 57.8% versus 63.5%).


CONCLUSIONS
For CD5+ DLBCL, the addition of rituximab to chemotherapy significantly improved the PFS, but not OS. Therefore, it is thought that a new treatment strategy is necessary for CD5+ DLBCL.
Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama; Adult Lymphoma Treatment Study Group, Nagoya, Japan. Electronic address: nniitsu@saitama-med.ac.jp.
N
N
Niitsu
Adult Lymphoma Treatment Study Group, Nagoya, Japan.
M
M
Okamoto
Adult Lymphoma Treatment Study Group, Nagoya, Japan.
J-I
JI
Tamaru
Adult Lymphoma Treatment Study Group, Nagoya, Japan.
T
T
Yoshino
Adult Lymphoma Treatment Study Group, Nagoya, Japan.
N
N
Nakamura
Adult Lymphoma Treatment Study Group, Nagoya, Japan.
S
S
Nakamura
Adult Lymphoma Treatment Study Group, Nagoya, Japan.
K
K
Ohshima
Adult Lymphoma Treatment Study Group, Nagoya, Japan.
H
H
Nakamine
Adult Lymphoma Treatment Study Group, Nagoya, Japan.
M
M
Hirano
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018956:CD5 Antigens / Q000378:metabolism*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D000069283:Rituximab; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D018956:CD5 Antigens; D000069283:Rituximab