Prognostic significance of PCR-based molecular staging in patients with diffuse large B-cell lymphoma treated with R-CHOP immunochemotherapy.
The prognostic role of detecting clonal immunoglobulin gene rearrangement (IgR) from bone marrow (BM) aspirates was evaluated by BIOMED-2 PCR in 97 patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab-CHOP immunochemotherapy. Sixteen (16.5%) patients had BM involvement (BMI) defined by BM biopsy (MOR+) and 39 (40.2%) had positive IgR (PCR+). Patients with MOR + BMI showed inferior event-free survival (EFS) compared to those with MOR-/PCR- (p < 0.001) or those with MOR-/PCR + BMI (p = 0.002), while no significant difference in EFS was observed between patients with MOR-/PCR + and those with MOR-/PCR - BMI (p = 0.497). Use of the BIOMED-2 for PCR resulted in significant increase in detection of BMI. However, the increased sensitivity by PCR did not translate into improved prediction of prognosis, emphasizing the essential role of histopathological review of trephine biopsy for the detection of BMI.
a Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon Regional Cancer Center , Gachon University College of Medicine , Incheon , Republic of Korea.
Ja Young
JY
Seo
b Department of Internal Medicine, Gachon University Gil Medical Center , Incheon Regional Cancer Center, Gachon University College of Medicine , Incheon , Republic of Korea.
Junshik
J
Hong
b Department of Internal Medicine, Gachon University Gil Medical Center , Incheon Regional Cancer Center, Gachon University College of Medicine , Incheon , Republic of Korea.
Kayeong
K
Chun
a Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon Regional Cancer Center , Gachon University College of Medicine , Incheon , Republic of Korea.
Jihoon
J
Jeong
c Department of Preventive Medicine , Gachon University College of Medicine , Incheon , Republic of Korea.
Hyeongrae
H
Cho
a Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon Regional Cancer Center , Gachon University College of Medicine , Incheon , Republic of Korea.
Kyung Hee
KH
Kim
b Department of Internal Medicine, Gachon University Gil Medical Center , Incheon Regional Cancer Center, Gachon University College of Medicine , Incheon , Republic of Korea.
Jinny
J
Park
a Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon Regional Cancer Center , Gachon University College of Medicine , Incheon , Republic of Korea.
Jeong Yeal
JY
Ahn
a Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon Regional Cancer Center , Gachon University College of Medicine , Incheon , Republic of Korea.
Pil-Whan
PW
Park
a Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon Regional Cancer Center , Gachon University College of Medicine , Incheon , Republic of Korea.
Jae Hoon
JH
Lee
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*; D014408:Biomarkers, Tumor; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D060965:Clonal Evolution / Q000235:genetics; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D015322:Gene Rearrangement, B-Lymphocyte; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D053208:Kaplan-Meier Estimate; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D016133:Polymerase Chain Reaction / Q000379:methods; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D016016:Proportional Hazards Models; D000069283:Rituximab; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor; D007143:Immunoglobulin Heavy Chains; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
BIOMED-2; bone marrow involvement; clonality; diffuse large B-cell lymphoma; prognosis