title: Prognostication of diffuse large B-cell lymphoma in the rituximab era.
abstract: Predicting the prognosis of patients diagnosed with diffuse large B-cell lymphoma (DLBCL) has been a moving target over the last several years. While earlier prognostic models relied mainly on such clinical variables as age, stage of disease, and performance status, it has become evident from gene-expression microarray studies that DLBCL is a heterogeneous disease in terms of molecular pathogenesis and cell of origin. Despite providing considerable insight into disease biology, these techniques are not widely available and are, at least at present, not applicable to routine clinical practice. Furthermore, older prognostic models need to be revalidated and modified as improved therapeutic options become available. In this review, we discuss pertinent studies on individual biomarkers and pattern-based biomarker models, with an emphasis on markers evaluated in patients treated with rituximab-containing chemotherapy. We also discuss recent and ongoing therapeutic trials using drugs that target molecular markers and pathways involved in the pathogenesis of DLBCL or those that adversely influence prognosis. The ultimate goal of these efforts is to refine prognostication of DLBCL using widely available, reproducible, and consistently predictive biomarker models applicable to currently used chemoimmunotherapy, and to create a pathophysiologically based framework for the rational design of individually tailored therapy.
authors.affiliation: Division of Hematology, Department of Medicine, University of Minnesota and Hematology-Oncology Section, VA Medical Center, Minneapolis, MN 55417, USA.
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Ninan
authors.forename: Punit D
authors.initials: PD
authors.lastname: Wadhwa
authors.forename: Pankaj
authors.initials: P
authors.lastname: Gupta
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis / Q000235:genetics; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy*; D008954:Models, Biological; D011379:Prognosis; D000069283:Rituximab
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D000069283:Rituximab