J Korean Med Sci.  2011 Dec;26(12):1556-1562. 10.3346/jkms.2011.26.12.1556.

Prognostic Value of Immunohistochemical Biomarkers at Different Cut-off Values in Patients with Diffuse Large B-cell Lymphoma Treated with CHOP Chemotherapy

• Oh S
• Koo DH
• Suh C
• Kim S
• Park BH
• Kang J
• Huh J

• KMID: 1786010
• DOI: http://doi.org/10.3346/jkms.2011.26.12.1556

Abstract

Many predictive models have been proposed for better stratification of diffuse large B-cell lymphoma (DLBCL). Hans' algorithm has been widely used as standard to sub-classify DLBCL into germinal center B-cell (GCB) and non-GCB origins. However, there have been disagreements in the literature regarding its prognostic significance. Here, we retrospectively analyzed Hans' algorithm and the individual immunohistochemical biomarkers at different cut-off values (5%, 30%, 50% or 75%) in 94 Korean patients with DLBCL treated with combination chemotherapy with cyclophosphamide, daunorubicin, vincristine, and prednisone. No significant differences were observed between the GCB (18 patients, 19.1%) and non-GCB (76, 80.9%) groups. Among individual biomarkers, CD10 negativity (cut point: 30%) and bcl-6 positivity (cut point: 5%) were independent good prognostic markers in progression-free survival (PFS), whereas bcl-6 (cut point: 5%) positivity was an independent good prognostic marker in overall survival irrelevant of international prognostic index. The present study showed the lack of predictability of Hans' algorithm in DLBCL patients, and that CD10, Bcl-6 may have diverse prognostic significance at different cut-off values. Our results suggest that the proposed cut-off value may not be applied universally, and that the optimal cut-off value may need to be optimized for individual laboratory.

Keyword

Diffuse Large B-cell Lymphoma (DLBCL); Hans' Algorithm; Germinal Center B-cell (GCB); Non-germinal Center B-cell (Non-GCB); CHOP Chemotherapy; CD10; Bcl-6

MeSH Terms

Adult
Aged
Aged, 80 and over
Algorithms
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
Cyclophosphamide/therapeutic use
DNA-Binding Proteins/analysis
Doxorubicin/therapeutic use
Female
Humans
Lymphoma, Large B-Cell, Diffuse/classification/*drug therapy
Male
Middle Aged
Neprilysin/analysis
Prednisone/therapeutic use
Prognosis
Republic of Korea
Retrospective Studies
Tumor Markers, Biological/*analysis
Vincristine/therapeutic use

Figure

• 

  Fig. 1 Kaplan-Meier curves of progression-free survival (PFS) (A) and overall survival (OS) (B) based on stratifying diffuse large B cell lymphomas (DLBCL) into germinal center B-cell (GCB) and non-germinal center B-cell (non-GCB) groups.

• 

  Fig. 2 Kaplan-Meier curves of progression free survival (PFS) according to CD10 (cut-off 30%) (A) and bcl-6 (cut-off 5%) (B).

• 

  Fig. 3 Kaplan-Meier curves of overall survival (OS) according to bcl-6 (cut-off 5%).

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