title: A new biologic prognostic model based on immunohistochemistry predicts survival in patients with diffuse large B-cell lymphoma.
abstract: Biologic factors that predict the survival of patients with a diffuse large B-cell lymphoma, such as cell of origin and stromal signatures, have been discovered by gene expression profiling. We attempted to simulate these gene expression profiling findings and create a new biologic prognostic model based on immunohistochemistry. We studied 199 patients (125 in the training set, 74 in the validation set) with de novo diffuse large B-cell lymphoma treated with rituximab and CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or CHOP-like therapies, and immunohistochemical stains were performed on paraffin-embedded tissue microarrays. In the model, 1 point was awarded for each adverse prognostic factor: nongerminal center B cell-like subtype, SPARC (secreted protein, acidic, and rich in cysteine) < 5%, and microvascular density quartile 4. The model using these 3 biologic markers was highly predictive of overall survival and event-free survival in multivariate analysis after adjusting for the International Prognostic Index in both the training and validation sets. This new model delineates 2 groups of patients, 1 with a low biologic score (0-1) and good survival and the other with a high score (2-3) and poor survival. This new biologic prognostic model could be used with the International Prognostic Index to stratify patients for novel or risk-adapted therapies.
authors: Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE 68198-3135, USA.
authors: Anamarija M
authors: AM
authors: Perry
authors: Teresa M
authors: TM
authors: Cardesa-Salzmann
authors: Paul N
authors: PN
authors: Meyer
authors: Luis
authors: L
authors: Colomo
authors: Lynette M
authors: LM
authors: Smith
authors: Kai
authors: K
authors: Fu
authors: Timothy C
authors: TC
authors: Greiner
authors: Jan
authors: J
authors: Delabie
authors: Randy D
authors: RD
authors: Gascoyne
authors: Lisa
authors: L
authors: Rimsza
authors: Elaine S
authors: ES
authors: Jaffe
authors: German
authors: G
authors: Ott
authors: Andreas
authors: A
authors: Rosenwald
authors: Rita M
authors: RM
authors: Braziel
authors: Raymond
authors: R
authors: Tubbs
authors: James R
authors: JR
authors: Cook
authors: Louis M
authors: LM
authors: Staudt
authors: Joseph M
authors: JM
authors: Connors
authors: Laurie H
authors: LH
authors: Sehn
authors: Julie M
authors: JM
authors: Vose
authors: Armando
authors: A
authors: López-Guillermo
authors: Elias
authors: E
authors: Campo
authors: Wing C
authors: WC
authors: Chan
authors: Dennis D
authors: DD
authors: Weisenburger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001185:Artificial Intelligence; D015331:Cohort Studies; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005103:Expert Systems; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009363:Neoplasm Proteins / Q000378:metabolism; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D000069283:Rituximab; D016019:Survival Analysis; D046888:Tissue Array Analysis; D014750:Vincristine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D009363:Neoplasm Proteins; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone