title: Gene-expression profiling and not immunophenotypic algorithms predicts prognosis in patients with diffuse large B-cell lymphoma treated with immunochemotherapy.
abstract: Diffuse large B-cell lymphomas (DLBCLs) can be divided into germinal-center B cell-like (GCB) and activated-B cell-like (ABC) subtypes by gene-expression profiling (GEP), with the latter showing a poorer outcome. Although this classification can be mimicked by different immunostaining algorithms, their reliability is the object of controversy. We constructed tissue microarrays with samples of 157 DLBCL patients homogeneously treated with immunochemotherapy to apply the following algorithms: Colomo (MUM1/IRF4, CD10, and BCL6 antigens), Hans (CD10, BCL6, and MUM1/IRF4), Muris (CD10 and MUM1/IRF4 plus BCL2), Choi (GCET1, MUM1/IRF4, CD10, FOXP1, and BCL6), and Tally (CD10, GCET1, MUM1/IRF4, FOXP1, and LMO2). GEP information was available in 62 cases. The proportion of misclassified cases by immunohistochemistry compared with GEP was higher when defining the GCB subset: 41%, 48%, 30%, 60%, and 40% for Colomo, Hans, Muris, Choi, and Tally, respectively. Whereas the GEP groups showed significantly different 5-year progression-free survival (76% vs 31% for GCB and activated DLBCL) and overall survival (80% vs 45%), none of the immunostaining algorithms was able to retain the prognostic impact of the groups (GCB vs non-GCB). In conclusion, stratification based on immunostaining algorithms should be used with caution in guiding therapy, even in clinical trials.
authors: Department of Hematology and Pathology, Hospital Clínic, University of Barcelona, Barcelona, Spain.
authors: Gonzalo
authors: G
authors: Gutiérrez-García
authors: Teresa
authors: T
authors: Cardesa-Salzmann
authors: Fina
authors: F
authors: Climent
authors: Eva
authors: E
authors: González-Barca
authors: Santiago
authors: S
authors: Mercadal
authors: José L
authors: JL
authors: Mate
authors: Juan M
authors: JM
authors: Sancho
authors: Leonor
authors: L
authors: Arenillas
authors: Sergi
authors: S
authors: Serrano
authors: Lourdes
authors: L
authors: Escoda
authors: Salomé
authors: S
authors: Martínez
authors: Alexandra
authors: A
authors: Valera
authors: Antonio
authors: A
authors: Martínez
authors: Pedro
authors: P
authors: Jares
authors: Magdalena
authors: M
authors: Pinyol
authors: Adriana
authors: A
authors: García-Herrera
authors: Alejandra
authors: A
authors: Martínez-Trillos
authors: Eva
authors: E
authors: Giné
authors: Neus
authors: N
authors: Villamor
authors: Elías
authors: E
authors: Campo
authors: Luis
authors: L
authors: Colomo
authors: Armando
authors: A
authors: López-Guillermo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D007167:Immunotherapy; D053208:Kaplan-Meier Estimate; D016403:Lymphoma, Large B-Cell, Diffuse / Q000235:genetics* / Q000276:immunology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020411:Oligonucleotide Array Sequence Analysis; D011379:Prognosis; D000069283:Rituximab; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab