Bcl-2, Bcl-6, and the International Prognostic Index are prognostic indicators in patients with diffuse large B-cell lymphoma treated with rituximab-containing chemotherapy.
This study aimed to clarify the clinicopathological prognostic parameters of de novo diffuse large B-cell lymphoma (DLBCL) in the rituximab era. We examined the correlation of 22 clinicopathological parameters with progression-free survival (PFS), overall survival (OS), and primary refractory disease in 285 DLBCL patients treated with rituximab-containing chemotherapy. Complete response rate was 87%, overall response rate was 91%, 5-year PFS rate was 72%, and 5-year OS rate was 91%. By log-rank test, higher International Prognostic Index (IPI) (P < 0.0001), Bcl-2 positivity (P = 0.0013), Bcl-6 negativity (P = 0.0112), and no irradiation (P = 0.0371) were significantly correlated with shorter PFS; higher IPI (P = 0.0107), starry sky pattern (P = 0.0466), and no irradiation (P = 0.0264) correlated with shorter OS. In multivariate analyses, higher IPI (P = 0.0006), Bcl-2 positivity (P = 0.0015), and Bcl-6 negativity (P = 0.04) were significantly correlated with shorter PFS; higher IPI (P = 0.0045) correlated with shorter OS. Bcl-2 (P = 0.0029), Bcl-6 (P = 0.002), and IPI (P < 0.0001) were significantly correlated with primary refractory disease. In conclusion, Bcl-2 positivity, Bcl-6 negativity, and higher IPI were indicators of shorter PFS and OS plus primary refractory disease in patients with DLBCL in the rituximab era.
Department of Pathology and Clinical Laboratory, National Cancer Center Hospital, Tokyo, Japan. akmaeshi@ncc.go.jp
Akiko Miyagi
AM
Maeshima
Hirokazu
H
Taniguchi
Suguru
S
Fukuhara
Noriyuki
N
Morikawa
Wataru
W
Munakata
Dai
D
Maruyama
Sung-Won
SW
Kim
Takashi
T
Watanabe
Yukio
Y
Kobayashi
Kensei
K
Tobinai
Hitoshi
H
Tsuda
D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D004268:DNA-Binding Proteins / Q000378:metabolism*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D053208:Kaplan-Meier Estimate; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000378:metabolism* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism*; D051560:Proto-Oncogene Proteins c-bcl-6; D000069283:Rituximab
D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; C084103:BCL6 protein, human; D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; D019253:Proto-Oncogene Proteins c-bcl-2; D051560:Proto-Oncogene Proteins c-bcl-6; D000069283:Rituximab