title: CD40 is a potential marker of favorable prognosis in patients with diffuse large B-cell lymphoma treated with immunochemotherapy.
abstract: We have previously shown that expression of CD40 has a favorable prognostic impact in diffuse large B-cell lymphoma (DLBCL) after anthracycline-based chemotherapy. Here we examined the prognostic value of immunohistochemically defined CD40 expression in 95 patients with DLBCL treated with both anthracycline-based chemotherapy and rituximab. Using a 10% cut-off level, 77% of the patients had CD40-positive tumors and showed a superior overall survival (p = 0.02 log-rank, hazard ratio 0.35, 95% CI 0.14-0.88, p = 0.03 Cox regression). When adjusted for International Prognostic Index in multivariate analysis, CD40 was not an independent prognostic factor (hazard ratio 0.39, 95% CI 0.15-1.04, p = 0.06 Cox regression). However, even after the introduction of immunochemotherapy, CD40 has a potential prognostic impact in DLBCL. Additional and larger studies are necessary, regarding the immunohistochemical robustness of CD40 and the biological mechanisms that contribute to the superior prognosis in CD40-expressing DLBCL.
authors.affiliation: Department of Oncology, Institution of Clinical Sciences, Lund University and Lund University Hospital, Lund, Sweden. karin.rydstrom@skane.se
authors.forename: Karin
authors.initials: K
authors.lastname: Rydström
authors.forename: Johan
authors.initials: J
authors.lastname: Linderoth
authors.forename: Heidi
authors.initials: H
authors.lastname: Nyman
authors.forename: Mats
authors.initials: M
authors.lastname: Ehinger
authors.forename: Patrick
authors.initials: P
authors.lastname: Joost
authors.forename: Pär-Ola
authors.initials: PO
authors.lastname: Bendahl
authors.forename: Sirpa
authors.initials: S
authors.lastname: Leppä
authors.forename: Mats
authors.initials: M
authors.lastname: Jerkeman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D019013:CD40 Antigens / Q000378:metabolism*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004268:DNA-Binding Proteins / Q000378:metabolism; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007167:Immunotherapy; D050835:Interferon Regulatory Factors / Q000378:metabolism; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D051560:Proto-Oncogene Proteins c-bcl-6; D000069283:Rituximab; D015996:Survival Rate; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult; D000099218:Interferon Regulatory Factor-4
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor; D019013:CD40 Antigens; D003520:Cyclophosphamide; D004268:DNA-Binding Proteins; D004317:Doxorubicin; D050835:Interferon Regulatory Factors; D011241:Prednisone; D019253:Proto-Oncogene Proteins c-bcl-2; D051560:Proto-Oncogene Proteins c-bcl-6; D000069283:Rituximab; D014750:Vincristine; D000099218:Interferon Regulatory Factor-4; C084103:BCL6 protein, human