Blood Res.  2014 Sep;49(3):162-169. 10.5045/br.2014.49.3.162.

Influence of NK cell count on the survival of patients with diffuse large B-cell lymphoma treated with R-CHOP

• Kim JK
• Chung JS
• Shin HJ
• Song MK
• Yi JW
• Shin DH
• Lee DS
• Baek SM

• KMID: 2172787
• DOI: http://doi.org/10.5045/br.2014.49.3.162

Abstract

BACKGROUND
Although adding rituximab to the chemotherapy regimen of cyclophosphamide, vincristine, doxorubicin, and prednisone (R-CHOP) has improved clinical outcomes of patients with diffuse large B-cell lymphoma (DLBCL), several recent studies have shown that the effect of rituximab is dominantly in the non-germinal center (non-GC) subtype compared to the germinal center (GC) subtype. Natural killer (NK) cell count, a surrogate marker of immune status, is associated with clinical outcomes in DLBCL patients in the rituximab era. We investigated whether the impact of NK cells on clinical outcomes differed according to the immunophenotype of DLBCL.
METHODS
This study analyzed 72 DLBCL patients treated with R-CHOP between January 2010 and January 2014.
RESULTS
Low NK cell counts (<100/microL) were associated with poor progression-free survival (PFS) and overall survival (OS) compared to high NK cell counts. In multivariate analysis, low NK cell count was an independent prognostic factor for PFS and OS. However, survival did not significantly differ between the GC and non-GC subtypes. We examined the clinical influence of NK cells according to the immunophenotype and found that low NK cell counts were significantly associated with poor PFS and OS in non-GC cases, but not in GC cases.
CONCLUSION
Low NK cell counts at diagnosis are associated with poor clinical outcomes in DLBCL patients treated with R-CHOP therapy. However, the impact is significant only in non-GC subtype DLBCL, not in the GC subtype.

Keyword

Natural killer cell coun; Diffuse large B-cell lymphoma; Rituximab; Germinal center type; Non-germinal center type

MeSH Terms

Biomarkers
Cell Count
Cyclophosphamide
Diagnosis
Disease-Free Survival
Doxorubicin
Drug Therapy
Germinal Center
Humans
Killer Cells, Natural*
Lymphoma, B-Cell*
Multivariate Analysis
Prednisone
Vincristine
Rituximab
Cyclophosphamide
Doxorubicin
Prednisone
Vincristine

Figure

• 

  Fig. 1 Comparison of clinical outcomes according to immunohistochemical staining for germinal center (GC) versus non-GC subtype (A, B) or natural killer (NK) cell counts in the entire population with diffuse large B-cell lymphoma (C, D).

• 

  Fig. 2 Comparison of clinical outcomes according to natural killer (NK) cell counts in germinal center (GC) type (A, B) or non-GC type (C, D).

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