title: Prognostic value of immunohistochemical biomarkers at different cut-off values in patients with diffuse large B-cell lymphoma treated with CHOP chemotherapy.
abstract: Many predictive models have been proposed for better stratification of diffuse large B-cell lymphoma (DLBCL). Hans' algorithm has been widely used as standard to sub-classify DLBCL into germinal center B-cell (GCB) and non-GCB origins. However, there have been disagreements in the literature regarding its prognostic significance. Here, we retrospectively analyzed Hans' algorithm and the individual immunohistochemical biomarkers at different cut-off values (5%, 30%, 50% or 75%) in 94 Korean patients with DLBCL treated with combination chemotherapy with cyclophosphamide, daunorubicin, vincristine, and prednisone. No significant differences were observed between the GCB (18 patients, 19.1%) and non-GCB (76, 80.9%) groups. Among individual biomarkers, CD10 negativity (cut point: 30%) and bcl-6 positivity (cut point: 5%) were independent good prognostic markers in progression-free survival (PFS), whereas bcl-6 (cut point: 5%) positivity was an independent good prognostic marker in overall survival irrelevant of international prognostic index. The present study showed the lack of predictability of Hans' algorithm in DLBCL patients, and that CD10, Bcl-6 may have diverse prognostic significance at different cut-off values. Our results suggest that the proposed cut-off value may not be applied universally, and that the optimal cut-off value may need to be optimized for individual laboratory.
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Sukjoong
authors.initials: S
authors.lastname: Oh
authors.forename: Dong Hoe
authors.initials: DH
authors.lastname: Koo
authors.forename: Cheolwon
authors.initials: C
authors.lastname: Suh
authors.forename: Shin
authors.initials: S
authors.lastname: Kim
authors.forename: Bong Hee
authors.initials: BH
authors.lastname: Park
authors.forename: Joon
authors.initials: J
authors.lastname: Kang
authors.forename: Jooryung
authors.initials: J
authors.lastname: Huh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis*; D003520:Cyclophosphamide / Q000627:therapeutic use; D004268:DNA-Binding Proteins / Q000032:analysis; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000145:classification / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015260:Neprilysin / Q000032:analysis; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D051560:Proto-Oncogene Proteins c-bcl-6; D056910:Republic of Korea; D012189:Retrospective Studies; D014750:Vincristine / Q000627:therapeutic use
chemical_list: C084103:BCL6 protein, human; D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; D051560:Proto-Oncogene Proteins c-bcl-6; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D015260:Neprilysin; D011241:Prednisone