title: Prognostic effect of Ki-67 expression in rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone-treated diffuse large B-cell lymphoma is limited to non-germinal center B-cell-like subtype in late-elderly patients.
abstract: This study evaluated the effect of age and cell of origin on the prognostic significance of Ki-67 labeling index (Ki-67 LI) on overall survival (OS) of diffuse large B-cell lymphoma (DLBCL) in a cohort of 697 patients treated with rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP). Multivariate analysis revealed no prognostic significance of high Ki-67 LI (≥ 85%) for OS. However, on subgroup analysis, high Ki-67 LI was significantly associated with poor OS in late-elderly patients (aged ≥ 70 years) (p = 0.021) and non-germinal center B-cell-like (GCB) subtype (p = 0.015). In particular, high Ki-67 LI was associated with a poor prognosis in late-elderly patients with non-GCB subtype. No correlation was observed in young adults (aged < 60 years) or early-elderly (aged 60-70 years) patients or GCB subtype. The present study shows that high Ki-67 LI is a risk factor for poor OS in the late-elderly age group and non-GCB subtype in patients with DLBCL treated with R-CHOP.
authors.affiliation: a Department of Pathology , Ajou University School of Medicine , Suwon , Korea.
authors.forename: Young Wha
authors.initials: YW
authors.lastname: Koh
authors.affiliation: b Department of Pathology , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Korea.
authors.forename: Hee Sang
authors.initials: HS
authors.lastname: Hwang
authors.affiliation: b Department of Pathology , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Korea.
authors.forename: Chan-Sik
authors.initials: CS
authors.lastname: Park
authors.affiliation: c Department of Oncology , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Korea.
authors.forename: Dok Hyun
authors.initials: DH
authors.lastname: Yoon
authors.affiliation: c Department of Oncology , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Korea.
authors.forename: Cheolwon
authors.initials: C
authors.lastname: Suh
authors.affiliation: b Department of Pathology , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Korea.
authors.forename: Jooryung
authors.initials: J
authors.lastname: Huh
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016175:B-Lymphocyte Subsets / Q000378:metabolism* / Q000473:pathology; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D015870:Gene Expression; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000235:genetics / Q000378:metabolism*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D000069283:Rituximab; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D019394:Ki-67 Antigen; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: Diffuse large B-cell lymphoma; Ki-67; elderly; non-GCB