1
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Lee KR, Lee JO, Lee JS, Paik JH. Bcl-6-dependent risk stratification by nuclear expression of Peli1 in diffuse large B-cell lymphoma. J Cancer 2022; 13:3598-3605. [PMID: 36606193 PMCID: PMC9809313 DOI: 10.7150/jca.67569] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/01/2022] [Indexed: 12/02/2022] Open
Abstract
Background/Aim: Peli1 is an E3 ubiquitin ligase involving lymphomagenesis by lysine 63 ubiquitination-mediated stabilization of Bcl-6 with in diffuse large B-cell lymphoma (DLBCL). Materials and Methods: We categorized nuclear expression of Peli1 according to Bcl-6 status by immunohistochemistry in DLBCL (n=100), and analyzed clinicopathologic association with prognosis. Results: We established Bcl-6/Peli1 risk model composed of high risk (Bcl-6+/Peli1+ or Bcl-6-/Peli1-; n=64) and low risk (Bcl-6+/Peli1- or Bcl-6-/Peli1+; n=36). High risk group had more frequent non-GCB subtype (83% vs 64%; p=0.033) and Bcl-6-negativity (69% vs 28%; p<0.001) than low risk group. Univariate survival analysis for progression-free survival (PFS) and overall survival (OS) revealed Bcl-6/Peli1 risk group (p=0.026 and p=0.021) and other conventional variables including international prognostic index (IPI), stage, ECOG performance status, number of extranodal sites were significant prognostic factors, along with B symptoms for OS. In multivariate analysis for PFS, Bcl-6/Peli1 risk group (p=0.032; HR=3.29), IPI (p=0.013; HR=3.39) and ECOG PS (p=0.035; HR=3.08) were independent prognostic factors. In multivariate analysis for OS, Bcl-6/Peli1 risk group (p=0.048; HR=7.87) and IPI (p=0.001; HR=12.15) were associated with prognosis. Conclusions: DLBCL had distinctive risk groups according to pairs of nuclear Peli1 and Bcl-6 expression. These results suggest the potential role of Peli1 and Bcl-6 in risk assessment in DLBCL.
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Affiliation(s)
- Ki Rim Lee
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam, South Korea,Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea
| | - Jeong-Ok Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Jong Seok Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Jin Ho Paik
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam, South Korea,Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea,✉ Corresponding author: Jin Ho Paik, MD, PhD, Department of Pathology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, South Korea. Tel.: +82-31-787-7717; Fax: +82-31-787-4012; E-mail:
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2
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Costa CBTD. Machine Learning Provides an Accurate Classification of Diffuse Large B-Cell Lymphoma from Immunohistochemical Data. J Pathol Inform 2018; 9:21. [PMID: 30034919 PMCID: PMC6029013 DOI: 10.4103/jpi.jpi_14_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 05/08/2018] [Indexed: 12/11/2022] Open
Abstract
Background: The classification of diffuse large B-cell lymphomas into Germinal Center (GCB) and non-GC subtypes defines disease subgroups which are different both in terms of gene expression and prognosis. Given their clinical significance, several classification algorithms have been designed, some by making use of widely availability immunohistochemical techniques. Despite their high concordance with gene expression profiles (GEP) and prognostic value, these algorithms were based on technical and biological assumptions that could be improved in terms of performance for classification. Methods: In order to overcome this limitation, a new algorithm was obtained by analyzing a previously published dataset of 475 patients by using an automatic classification tree method. Results: The resulting algorithm classifies correctly 91.6% of the cases when compared to GEP, displaying a Receiver-Operator Characteristic (ROC) area under the curve of 0.934. Noteworthy features of this algorithm include the capability to classify GEP-unclassifiable cases and a significant prognostic value, both in terms of overall survival (60 months for non-GC vs not reached for GCB, P = 0.007) and progression-free survival (61.9 months vs not reached, P = 0.017). Conclusion: By using a machine learning classification method that avoids most pre-assumptions, the novel algorithm obtained is accurate and maintains relevant features for clinical implementation.
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3
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Franco R, Scognamiglio G, Valentino E, Vitiello M, Luciano A, Palma G, Arra C, La Mantia E, Panico L, Tenneriello V, Pinto A, Frigeri F, Capobianco G, Botti G, Cerchia L, De Chiara A, Fedele M. PATZ1 expression correlates positively with BAX and negatively with BCL6 and survival in human diffuse large B cell lymphomas. Oncotarget 2018; 7:59158-59172. [PMID: 27494852 PMCID: PMC5312302 DOI: 10.18632/oncotarget.10993] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 07/18/2016] [Indexed: 12/18/2022] Open
Abstract
Non-Hodgkin lymphomas (NHLs) include a heterogeneous group of diseases, which differ in both cellular origin and clinical behavior. Among the aggressive malignancies of this group, the diffuse large B-cell lymphomas (DLBCLs) are the most frequently observed. They are themselves clinically and molecularly heterogeneous and have been further sub-divided in three sub-types according to different cell of origin, mechanisms of oncogenesis and clinical outcome. Among them, the germinal center B-cell-like (GCB) derives from the germinal center and expresses the BCL6 oncogene. We have previously shown that Patz1-knockout mice develop B-cell neoplasias, suggesting a tumor suppressor role for PATZ1 in human NHLs. Here, by immunohistochemical analysis of a tissue-microarray including 170 NHLs, we found that PATZ1 nuclear expression is down-regulated in follicular lymphomas and DLBCLs. Moreover, consistent with our previous results showing a PATZ1-dependent regulation of BCL6 and BAX transcription, we show that low PATZ1 nuclear expression significantly correlates with high BCL6 expression, mainly in DLBCLs, and with low BAX expression, also considering separately follicular lymphomas and DLBCLs. Finally, by analyzing overall and progression-free survival in DLBCL patients that underwent rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy, low levels of PATZ1 were significantly associated to a worst outcome and demonstrated an independent prognostic factor in multivariate analysis, including known prognostic factors of DLBCL, IPI score and cell of origin (GCB/non-GCB). Therefore, we propose PATZ1 as a new prognostic marker of DLBCLs, which may act as a tumor suppressor by enhancing apoptosis through inhibiting and enhancing transcription of BCL6 and BAX, respectively.
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Affiliation(s)
- Renato Franco
- Surgical Pathology Unit, National Cancer Institute 'Fondazione Giovanni Pascale', IRCCS, Naples, Italy.,Pathology Unit, Second University of Naples, Naples, Italy
| | - Giosuè Scognamiglio
- Surgical Pathology Unit, National Cancer Institute 'Fondazione Giovanni Pascale', IRCCS, Naples, Italy
| | - Elena Valentino
- Surgical Pathology Unit, National Cancer Institute 'Fondazione Giovanni Pascale', IRCCS, Naples, Italy
| | - Michela Vitiello
- Institute of Experimental Endocrinology and Oncology (IEOS), National Research Council (CNR), Naples, Italy
| | - Antonio Luciano
- Animal Facility, National Cancer Institute 'Fondazione Giovanni Pascale', IRCCS, Naples, Italy
| | - Giuseppe Palma
- Animal Facility, National Cancer Institute 'Fondazione Giovanni Pascale', IRCCS, Naples, Italy
| | - Claudio Arra
- Animal Facility, National Cancer Institute 'Fondazione Giovanni Pascale', IRCCS, Naples, Italy
| | - Elvira La Mantia
- Surgical Pathology Unit, National Cancer Institute 'Fondazione Giovanni Pascale', IRCCS, Naples, Italy
| | - Luigi Panico
- Pathology Unit, Hospital 'S.G. Moscati', Avellino, Italy
| | | | - Antonello Pinto
- Haematology-Oncology and Stem Cell Transplantation Unit, Department of Hematology, National Cancer Institute, Fondazione 'G. Pascale', IRCCS, Naples, Italy
| | - Ferdinando Frigeri
- Haematology-Oncology and Stem Cell Transplantation Unit, Department of Hematology, National Cancer Institute, Fondazione 'G. Pascale', IRCCS, Naples, Italy
| | - Gaetana Capobianco
- Haematology-Oncology and Stem Cell Transplantation Unit, Department of Hematology, National Cancer Institute, Fondazione 'G. Pascale', IRCCS, Naples, Italy
| | - Gerardo Botti
- Surgical Pathology Unit, National Cancer Institute 'Fondazione Giovanni Pascale', IRCCS, Naples, Italy
| | - Laura Cerchia
- Institute of Experimental Endocrinology and Oncology (IEOS), National Research Council (CNR), Naples, Italy
| | - Annarosaria De Chiara
- Surgical Pathology Unit, National Cancer Institute 'Fondazione Giovanni Pascale', IRCCS, Naples, Italy
| | - Monica Fedele
- Institute of Experimental Endocrinology and Oncology (IEOS), National Research Council (CNR), Naples, Italy
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4
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Fukuhara S, Nomoto J, Kim SW, Taniguchi H, Miyagi Maeshima A, Tobinai K, Kobayashi Y. Partial deletion of the ALK gene in ALK-positive anaplastic large cell lymphoma. Hematol Oncol 2017; 36:150-158. [PMID: 28665006 DOI: 10.1002/hon.2455] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 06/03/2017] [Accepted: 06/05/2017] [Indexed: 12/20/2022]
Abstract
Anaplastic lymphoma kinase (ALK) protein is an orphan receptor tyrosine kinase that is constitutively activated by aberrant translocations of the ALK gene in anaplastic large cell lymphoma, ALK-positive and several other cancers. Additionally, aberrant mutation and amplification of the ALK gene, resulting in ALK kinase activation, were detected mainly in neuroblastoma. Recently, truncated ALK protein was also reported in neuroblastoma. Here, we describe a novel truncated form of the ALK transcript with in-frame skipping through exons 2 to 17 (ALKΔ2-17) in anaplastic large cell lymphoma, ALK-positive. The ALKΔ2-17 showed ligand-independent deregulated phosphorylation that initiated strong STAT3 signalling in NIH3T3 cells. The ALKΔ2-17-transduced NIH3T3 cells showed oncogenic potential in a colony formation assay. Our data indicate that the aberrant deletion of the ALK gene might be oncogenic, providing a novel insight into the oncogenic role of the ALK pathway.
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Affiliation(s)
- Suguru Fukuhara
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan.,Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo, Japan
| | - Junko Nomoto
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Sung-Won Kim
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | | | | | - Kensei Tobinai
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Yukio Kobayashi
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
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5
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Schmidt-Hansen M, Berendse S, Marafioti T, McNamara C. Does cell-of-origin or MYC, BCL2 or BCL6 translocation status provide prognostic information beyond the International Prognostic Index score in patients with diffuse large B-cell lymphoma treated with rituximab and chemotherapy? A systematic review. Leuk Lymphoma 2017; 58:2403-2418. [DOI: 10.1080/10428194.2017.1287364] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Mia Schmidt-Hansen
- National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London, UK
| | - Sabine Berendse
- National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London, UK
| | - Teresa Marafioti
- Department of Histopathology, University College London Hospital, London, UK
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6
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Tada K, Maeshima AM, Hiraoka N, Yamauchi N, Maruyama D, Kim SW, Watanabe T, Katayama N, Heike Y, Tobinai K, Kobayashi Y. Prognostic significance of HLA class I and II expression in patients with diffuse large B cell lymphoma treated with standard chemoimmunotherapy. Cancer Immunol Immunother 2016; 65:1213-22. [PMID: 27522583 PMCID: PMC11029644 DOI: 10.1007/s00262-016-1883-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 08/06/2016] [Indexed: 12/17/2022]
Abstract
Loss of tumor cell human leukocyte antigen (HLA) is an immune escape mechanism for malignancies. However, the effect of low HLA class I or class II expression in diffuse large B cell lymphoma (DLBCL) treated with chemoimmunotherapy with the monoclonal antibody rituximab is largely unknown. We retrospectively analyzed samples and other data from 144 patients with DLBCL who were newly diagnosed in our institution and treated with standard R-CHOP therapy. We used antibodies against pan-HLA class I and pan-HLA class II molecules to assess HLA expression and its effect on prognosis. In a multivariate analysis, loss of HLA class II expression was a significantly independent adverse factor for progression-free survival (PFS; hazard ratio 2.3; 95 % confidence interval 1.2-4.6; P = 0.01). Although HLA class I loss of expression did not correlate with prognosis, the combination of HLA class I(+) with either low peripheral lymphocyte count or CD3(+) lymphocyte count was an adverse prognostic factor for PFS. Loss of HLA class II is an International Prognostic Index (IPI)-independent adverse factor for PFS in patients with DLBCL treated with standard therapy. However, in contrast to other solid cancers, HLA class I loss was not solely a prognostic factor in DLBCL.
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Affiliation(s)
- Kohei Tada
- Department of Hematology and Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
- Immunotherapy and Cell Therapy Service, St. Luke's International Hospital, Tokyo, Japan
| | - Akiko Miyagi Maeshima
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Nobuyoshi Hiraoka
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Nobuhiko Yamauchi
- Department of Hematology and Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Dai Maruyama
- Department of Hematology and Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Sung-Won Kim
- Department of Hematology and Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Takashi Watanabe
- Department of Hematology and Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- Department of Immuno-Gene Therapy, Mie University Graduate School of Medicine, Tsu, Japan
| | - Naoyuki Katayama
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yuji Heike
- Immunotherapy and Cell Therapy Service, St. Luke's International Hospital, Tokyo, Japan
- Immunotherapy Research Field, Translational Research Group, and Translational Medicine Department, Phase 1 Group, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Tokyo, Japan
| | - Kensei Tobinai
- Department of Hematology and Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yukio Kobayashi
- Department of Hematology and Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
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7
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Ji D, Li Q, Cao J, Guo Y, Lv F, Liu X, Wang B, Wang L, Luo Z, Chang J, Wu X, Hong X. Thalidomide enhanced the efficacy of CHOP chemotherapy in the treatment of diffuse large B cell lymphoma: A phase II study. Oncotarget 2016; 7:33331-9. [PMID: 27129176 PMCID: PMC5078098 DOI: 10.18632/oncotarget.8973] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 04/02/2016] [Indexed: 02/05/2023] Open
Abstract
Cyclophosphamide, doxorubicin, vincristine, and prednisolone plus rituximab (R-CHOP) is the standard treatment for patients with diffuse large B cell lymphoma (DLBCL). However, rituximab cannot be popularly applied in a considerable number of patients with DLBCL because of economic reasons. To develop a new regimen to improve the outcome of these patients is extremely important. In our study, sixty five patients with DLBCL were randomly assigned to thalidomide plus CHOP group (n=32) or to CHOP alone group (n=33). Objective response rates (ORR) and complete remission rates (CRR) were 96.7% and 80.6% in T-CHOP group versus 78.9 % and 57.8 % in CHOP group, respectively (P <0.05). At a median follow-up of 96 months, median PFS for T-CHOP group was still not reached yet, and in CHOP group it was 22.9 months (95% CI [0-50.4]). (P=0.163). Median overall survival (OS) for T-CHOP group was also not reached, and the estimated median OS for CHOP group was 83.5 months, the difference of OS between the two groups is not significant (p=0.263). But, in patients with Bcl-2 positive and Bcl-6 negative, the median PFS in T-CHOP group was longer than that in CHOP group (111.0 vs 8.5 months (P=0.017). In addition, thalidomide did not significantly increase the grade 3/4 toxicity of CHOP. We concluded that the addition of thalidomide to the CHOP regimen significantly improved the CRR and showed a trend of improving clinical outcome in patients with DLBCL, especially for patients with Bcl-2 positive and Bcl-6 negative B-cell phenotype, without increased toxicity.
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Affiliation(s)
- Dongmei Ji
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Qiu Li
- Department of Medical Oncology, West China Hospital of Medicine, Sichuan University, Chengdu 610041, P.R. China
| | - Junning Cao
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Ye Guo
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Fangfang Lv
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Xiaojian Liu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Biyun Wang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Leiping Wang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Zhiguo Luo
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Jianhua Chang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Xianghua Wu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Xiaonan Hong
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
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8
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Choi YW, Ahn MS, Choi JH, Lee HW, Kang SY, Jeong SH, Park JS, Han JH, Kim JH, Sheen SS. High expression of Bcl-2 predicts poor outcome in diffuse large B-cell lymphoma patients with low international prognostic index receiving R-CHOP chemotherapy. Int J Hematol 2015; 103:210-8. [PMID: 26586460 DOI: 10.1007/s12185-015-1911-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 11/11/2015] [Accepted: 11/12/2015] [Indexed: 11/24/2022]
Abstract
The prognostic significance of Bcl-2, Bcl-6, p53, topoisomerase II, and β-tubulin expression was evaluated in diffuse large B-cell lymphoma (DLBCL) patients treated with cyclophosphamide, doxorubicin, vincristine, prednisolone, and rituximab. Eight-year progression-free survival (PFS, P = 0.006) and overall survival (OS, P = 0.001) of patients with high Bcl-2 expression were significantly inferior to those of patients with low expression without prognostic significance of Bcl-6, p53, topoisomerase II, and β-tubulin expression. High expression of Bcl-2 was associated with poor PFS (P = 0.045) and OS (P = 0.004) only in patients with low international prognostic index (IPI). In multivariate analysis, high expression of Bcl-2 was a significant independent prognostic factor of poor PFS (P = 0.026) and OS (P = 0.007) along with high IPI. In conclusion, the expression of Bcl-2 may be a useful prognostic factor, especially in DLBCL patients with low IPI.
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Affiliation(s)
- Yong Won Choi
- Department of Hematology-Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-Gu, Suwon, 16499, Republic of Korea
| | - Mi Sun Ahn
- Department of Hematology-Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-Gu, Suwon, 16499, Republic of Korea
| | - Jin-Hyuk Choi
- Department of Hematology-Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-Gu, Suwon, 16499, Republic of Korea
| | - Hyun Woo Lee
- Department of Hematology-Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-Gu, Suwon, 16499, Republic of Korea.
| | - Seok Yun Kang
- Department of Hematology-Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-Gu, Suwon, 16499, Republic of Korea
| | - Seong Hyun Jeong
- Department of Hematology-Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-Gu, Suwon, 16499, Republic of Korea
| | - Joon Seong Park
- Department of Hematology-Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-Gu, Suwon, 16499, Republic of Korea
| | - Jae Ho Han
- Department of Pathology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-Gu, Suwon, 16499, Republic of Korea.
| | - Jang-Hee Kim
- Department of Pathology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-Gu, Suwon, 16499, Republic of Korea
| | - Seung Soo Sheen
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
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9
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Wang J, Zhou M, Xu JY, Chen B, Ouyang J. Combination of BCL-2 and MYC protein expression improves high-risk stratification in diffuse large B-cell lymphoma. Onco Targets Ther 2015; 8:2645-50. [PMID: 26425100 PMCID: PMC4583112 DOI: 10.2147/ott.s86093] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate whether the addition of two biological markers (MYC and BCL-2 protein overexpression) improves the stratification of high-risk patients with diffuse large B-cell lymphoma (DLBCL). Method Seven risk factors were identified at diagnosis, and a maximum of 7 points were assigned to each patient. The patients were classified according to four risk groups: low (0–1), low-intermediate (2–3), high-intermediate (4), and high (5–7). Only high-risk patients with DLBCL were included in this analysis. We retrospectively examined 20 cases from 2008 to 2013 at the Nanjing Drum Tower Hospital. Results The median expression of MYC protein was 60%, and 17 of 20 (65%) evaluable cases overexpressed MYC. The median expression of BCL-2 protein was also 60%. Eighteen of 20 (90%) evaluable cases showed BCL-2 overexpression. Additionally, 12 out of 20 cases (60%) demonstrated coexpression of MYC and BCL-2 proteins. The percentages of overall survival and progression-free survival at the median follow-up time (36 months) were 33.3%±16.1% and 16.9%±13.5%, respectively. By comparison, nine, four, and 20 patients were classified as high risk based on the International Prognostic Index (IPI), National Comprehensive Cancer Network(NCCN)-IPI, and revised IPI criteria, respectively. According to the IPI and NCCN-IPI stratification, the risk groups demonstrated closely overlapping survival curves. In addition, four out of 20 cases were identified as low-intermediate risk according to the NCCN-IPI criteria. Conclusion The addition of MYC and BCL-2 protein expression to the IPI could identify a subset of DLBCL patients with high-risk clinicopathological characteristics and poor clinical outcome.
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Affiliation(s)
- Jing Wang
- Department of Hematology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China
| | - Min Zhou
- Department of Hematology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China
| | - Jing-Yan Xu
- Department of Hematology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China
| | - Bing Chen
- Department of Hematology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China
| | - Jian Ouyang
- Department of Hematology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China
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10
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Maeshima AM, Taniguchi H, Miyamoto KI, Fukuhara S, Munakata W, Maruyama D, Kim SW, Kobayashi Y, Tobinai K, Kushima R. Prognostic significance of immunophenotypes and a nodular pattern in primary mediastinal large B-cell lymphoma. Pathol Int 2014; 64:382-7. [PMID: 25143126 DOI: 10.1111/pin.12186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 06/30/2014] [Indexed: 11/26/2022]
Abstract
To investigate the clinicopathological and prognostic significance of a nodular pattern and immunophenotypes in primary mediastinal large B-cell lymphoma (PMBL), histopathological features, including a nodular pattern and immunophenotypes, were analyzed in 58 Japanese PMBL patients. The patients were 23 men and 35 women with a median age of 31 years. The 4-year progression free survival (PFS) rate was 78%, and the 4-year overall survival (OS) rate was 89%. Among the histopathological and immunohistochemical features, Bcl6(+) (P = 0.013), MUM1(+) (P = 0.091), and pale cytoplasm (P = 0.064) were favorable prognostic indicators of PFS, and Bcl6(+) (P = 0.051) and MUM1(+) (P = 0.07) were favorable prognostic indicators of OS. Patients with Bcl2 negativity (n = 11) had 4-year PFS and OS rates of 100%. Histologically, a nodular pattern, resembling nodular sclerosis classical Hodgkin lymphoma (CHL), was observed in 22 patients (38%). However, this was not a significant prognostic indicator. In conclusion, Bcl6(+) , MUM1(+) , Bcl2(-) , and pale cytoplasm are candidate favorable prognostic indicators for PMBL and should be further examined in larger studies. We suggest that PMBL with a nodular pattern may belong to the same histological spectrum as nodular sclerosis CHL.
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Affiliation(s)
- Akiko Miyagi Maeshima
- Department of Pathology and Clinical Laboratory, National Cancer Center Hospital, Tokyo, Japan
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Maeshima AM, Taniguchi H, Nomoto J, Miyamoto KI, Fukuhara S, Munakata W, Maruyama D, Kim SW, Watanabe T, Kobayashi Y, Tobinai K, Tsuda H. Prognostic implications of histologic grade and intensity of Bcl-2 expression in follicular lymphomas undergoing rituximab-containing therapy. Hum Pathol 2013; 44:2529-35. [DOI: 10.1016/j.humpath.2013.06.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 06/19/2013] [Accepted: 06/21/2013] [Indexed: 10/26/2022]
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Coutinho R, Clear AJ, Owen A, Wilson A, Matthews J, Lee A, Alvarez R, Gomes da Silva M, Cabeçadas J, Calaminici M, Gribben JG. Poor concordance among nine immunohistochemistry classifiers of cell-of-origin for diffuse large B-cell lymphoma: implications for therapeutic strategies. Clin Cancer Res 2013; 19:6686-95. [PMID: 24122791 DOI: 10.1158/1078-0432.ccr-13-1482] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE The opportunity to improve therapeutic choices on the basis of molecular features of the tumor cells is on the horizon in diffuse large B-cell lymphoma (DLBCL). Agents such as bortezomib exhibit selective activity against the poor outcome activated B-cell type (ABC) DLBCL. In order for targeted therapies to succeed in this disease, robust strategies that segregate patients into molecular groups with high reliability are needed. Although molecular studies are considered gold standard, several immunohistochemistry (IHC) algorithms have been published that claim to be able to stratify patients according to their cell-of-origin and to be relevant for patient outcome. However, results are poorly reproducible by independent groups. EXPERIMENTAL DESIGN We investigated nine IHC algorithms for molecular classification in a dataset of DLBCL diagnostic biopsies, incorporating immunostaining for CD10, BCL6, BCL2, MUM1, FOXP1, GCET1, and LMO2. IHC profiles were assessed and agreed among three expert observers. A consensus matrix based on all scoring combinations and the number of subjects for each combination allowed us to assess reliability. The survival impact of individual markers and classifiers was evaluated using Kaplan-Meier curves and the log-rank test. RESULTS The concordance in patient's classification across the different algorithms was low. Only 4% of the tumors have been classified as germinal center B-cell type (GCB) and 21% as ABC/non-GCB by all methods. None of the algorithms provided prognostic information in the R-CHOP (rituximab plus cyclophosphamide-adriamycin-vincristine-prednisone)-treated cohort. CONCLUSION Further work is required to standardize IHC algorithms for DLBCL cell-of-origin classification for these to be considered reliable alternatives to molecular-based methods to be used for clinical decisions.
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Affiliation(s)
- Rita Coutinho
- Authors' Affiliations: Department of Hemato-Oncology, Barts Cancer Institute, Queen Mary University of London; Department of Histopathology, Barts Health NHS Trust, Royal London Hospital, London, United Kingdom; Departments of Hematology, and Pathology, Portuguese Institute of Oncology, Lisbon, Portugal
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Maeshima AM, Taniguchi H, Fukuhara S, Maruyama D, Kim SW, Watanabe T, Kobayashi Y, Tobinai K, Tsuda H. Clinicopathological prognostic indicators in 107 patients with diffuse large B-cell lymphoma transformed from follicular lymphoma. Cancer Sci 2013; 104:952-7. [PMID: 23521357 DOI: 10.1111/cas.12158] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 03/17/2013] [Accepted: 03/19/2013] [Indexed: 11/29/2022] Open
Abstract
Follicular lymphoma (FL) frequently transforms into diffuse large B-cell lymphoma (DLBCL). To clarify the associated clinicopathological prognostic parameters, we examined the correlation of 11 histopathological parameters with progression-free survival (PFS) and overall survival (OS) in 107 consecutive patients who had DLBCL with pre-existing (asynchronous) or synchronous FL. The patients comprised 58 men and 49 women with a median age of 56 years. For DLBCL, the complete response rate was 81%, overall response rate was 88%, and 5-year PFS and OS rates were 55% and 79%, respectively. Immunohistochemical analysis of the DLBCL component revealed the following positivity rates: CD10, 64%; Bcl-2, 83%; Bcl-6, 88%; MUM1, 42%; GCB, 82%; cMyc index ≥80%, 17%; and Ki-67 index ≥90%, 19%. IGH/BCL2 fusion was positive in 57% of DLBCL cases. In univariate analyses, asynchronous FL and DLBCL (24%, P = 0.021), 100% proportion of DLBCL (29%, P = 0.004), Bcl-2 positivity (P = 0.04), and high Ki-67 index (P = 0.003) were significantly correlated with shorter PFS. Asynchronous FL and DLBCL (P = 0.003), 100% proportion of DLBCL (P = 0.001), and high Ki-67 index (P = 0.004) were significantly correlated with shorter OS. In a multivariate analysis, asynchronous FL and DLBCL (P = 0.035) and 100% proportion of DLBCL (P = 0.016) were significantly correlated with shorter OS. Thus, asynchronism and 100% proportion of DLBCL, that is, FL relapsed as pure DLBCL, or FL and DLBCL at different sites, were significant predictors of unfavorable outcome of patients with DLBCL transformed from FL.
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Affiliation(s)
- Akiko M Maeshima
- Department of Pathology and Clinical Laboratory, National Cancer Center Hospital, Tokyo, Japan.
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New developments in the pathology of malignant lymphoma. A review of the literature published from January 2012–July 2012. J Hematop 2012. [DOI: 10.1007/s12308-012-0161-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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