title: Prognostic impact of CD5 expression in diffuse large B-cell lymphoma in patients treated with rituximab-EPOCH.
abstract: OBJECTIVE
  CD5-positive (CD5+) diffuse large B-cell lymphoma (DLBCL) represents 5%-10% of all DLBCL cases, which has been associated with a poorer prognosis in patients treated with R-CHOP. Prognostic impact of CD5 expression in patients with DLBCL treated with R-EPOCH has not been evaluated.
  
  
  METHODS
  We studied 130 patients with de novo DLBCL who received frontline R-EPOCH therapy. The clinicopathologic features and overall survival (OS) were compared between patients with CD5+ and CD5- DLBCL. MYC, BCL2, and BCL6 rearrangements were examined by fluorescent in situ hybridization.
  
  
  RESULTS
  Sixteen (12.3%) of 130 DLBCLs were CD5+. Most clinicopathologic features including cell of origin and frequency of MYC, BCL2, and BCL6 rearrangements were similar between CD5+ and CD5- groups. Patients with CD5+ DLBCL, however, showed higher rate of central nervous system relapse (33.3% vs 15.6%; P<.01) and a higher Ki67 proliferative index compared with CD5- patients. The median OS was significantly worse in CD5+ than CD5- patients (28.13 months vs not reached, P=.006). CD5 expression was an independent prognostic factor for OS in multivariate analysis.
  
  
  CONCLUSIONS
  R-EPOCH therapy does not seem to impact the known poorer prognosis of patients with de novo CD5+ DLBCL, and CD5 expression was still an independent prognostic factor in R-EPOCH-treated patients with DLBCL.
authors.affiliation: Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Beenu
authors.identifier: http://orcid.org/0000-0001-5140-3633
authors.initials: B
authors.lastname: Thakral
authors.affiliation: Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: L Jeffrey
authors.initials: LJ
authors.lastname: Medeiros
authors.affiliation: Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Parth
authors.initials: P
authors.lastname: Desai
authors.affiliation: Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Pei
authors.initials: P
authors.lastname: Lin
authors.affiliation: Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: C Cameron
authors.initials: CC
authors.lastname: Yin
authors.affiliation: Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Guilin
authors.initials: G
authors.lastname: Tang
authors.affiliation: Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Khoury
authors.affiliation: Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Shimin
authors.initials: S
authors.lastname: Hu
authors.affiliation: Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Jie
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Sanam
authors.initials: S
authors.lastname: Loghavi
authors.affiliation: Department of Lymphoma and Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Bei
authors.initials: B
authors.lastname: Hu
authors.affiliation: Department of Lymphoma and Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Oki
authors.affiliation: Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Shaoying
authors.initials: S
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D018956:CD5 Antigens / Q000096:biosynthesis*; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000096:biosynthesis*; D011241:Prednisone / Q000008:administration & dosage; D000069283:Rituximab / Q000008:administration & dosage*; D015996:Survival Rate; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D018956:CD5 Antigens; D009363:Neoplasm Proteins; D000069283:Rituximab; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: CD5; Ki67 index; R-EPOCH; central nervous system; diffuse large B-cell lymphoma