Prognostic markers in diffuse large B-cell lymphoma: Keys to the underlying biology.
Prognostic markers identify subgroups of patients with similar risk profiles, helping to guide clinical care. The addition of rituximab to conventional anthracycline-based chemotherapy has improved clinical outcomes for patients with diffuse large B-cell lymphoma (DLBCL). Studies suggest that rituximab eliminates or modulates the significance of some markers (eg, BCL6 or BCL2), whereas other previously unimportant markers may emerge as significant prognostic indicators in the setting of treatment that now includes rituximab. These changes in the prognostic profile are likely to reflect the impact of rituximab on survival pathways important to some groups of patients with DLBCL but not to other groups, and thereby may provide clues to the underlying biology of the disease. They also identify subgroups of patients likely to benefit most from rituximab therapy and those who seem to garner no advantage from its inclusion in their treatment. Studies of prognostic indicators in the context of modern therapy have the potential to identify new, rational therapeutic targets for this biologically diverse disease.
Winter
Jane N
JN
Division of Hematology-Oncology, Department of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Suite 850, 676 North St. Clair Street, Chicago, IL 60611, USA. j-winter@northwestern.edu
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D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; C084103:BCL6 protein, human; D014408:Biomarkers, Tumor; C493956:CDKN1A protein, human; D050759:Cyclin-Dependent Kinase Inhibitor p21; D004268:DNA-Binding Proteins; D007155:Immunologic Factors; D009363:Neoplasm Proteins; D019253:Proto-Oncogene Proteins c-bcl-2; D051560:Proto-Oncogene Proteins c-bcl-6; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53; D001613:beta 2-Microglobulin; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D007770:L-Lactate Dehydrogenase; D011241:Prednisone