title: Association of CD20 levels with clinicopathological parameters and its prognostic significance for patients with DLBCL.
abstract: Diffuse large B-cell lymphomas (DLBCL) express CD20. CD20 expression is described as negative, weak, or normal as determined by flow cytometry (FCM) and is an important target for the treatment of DLBCL. However, the impact of CD20 levels at onset of the disease on patient prognosis has not been fully elucidated. We analyzed 174 DLBCL cases newly diagnosed between January 1998 and April 2010. The relationship of the association between CD20 levels and patients' backgrounds and prognoses was analyzed using the Kaplan-Meier method and Cox proportional hazard regression. Of the 174 patients, three cases (1.7%) were defined as CD20 negative based on immunohistochemistry (IHC). Although the other 171 cases were positive by IHC, eight cases (4.7%) were defined as negative and 33 cases (19.3%) were defined as weak when analyzed by FCM. Of the 105 patients who received rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone therapy, those who were CD20 negative (FCM) showed significantly inferior overall (hazard ratios (HR): 6.79, 95% CI: 1.32-34.96, p = 0.04) and progression-free survival (HR: 7.3, 95% CI: 1.49-35.8, p = 0.04) compared to patients who were CD20 normal. Our findings indicate that the CD20 level (FCM) at onset is an independent predictor of the prognosis of patients with DLBCL.
authors.affiliation: Department of Hematology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0374, Japan. ysuzuki-hki@umin.ac.jp
authors.forename: Yuhko
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Yoshida
authors.forename: Guoqin
authors.initials: G
authors.lastname: Wang
authors.forename: Tomiteru
authors.initials: T
authors.lastname: Togano
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Koji
authors.initials: K
authors.lastname: Miyazaki
authors.forename: Keiichi
authors.initials: K
authors.lastname: Iwabuchi
authors.forename: Meijin
authors.initials: M
authors.lastname: Nakayama
authors.forename: Ryouichi
authors.initials: R
authors.lastname: Horie
authors.forename: Nozomi
authors.initials: N
authors.lastname: Niitsu
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sato
authors.forename: Naoya
authors.initials: N
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000009:adverse effects; D018951:Antigens, CD20 / Q000032:analysis* / Q000097:blood / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects; D014408:Biomarkers, Tumor / Q000032:analysis / Q000097:blood / Q000378:metabolism; D015331:Cohort Studies; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011379:Prognosis; D012189:Retrospective Studies; D000069283:Rituximab; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D014408:Biomarkers, Tumor; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone