Diffuse large B cell lymphoma (DLBCL) is the most common types of non-Hodgkin’s lympoma. Approximately half of all patients (pts) will be cured of their disease by primary therapy. Two major subgroups were identified by gene expression profiling: germinal centre B (GC) cell or non-germinal centre (non-GC). The GC group showes a significantly better survival than the non-GC group. Immunohistochemistry has been evaluated as a surrogate for this molecular classification. The aim of this study was to define retrospectively the B-cell origin of 40 pts treated with R-CHOP14 and to evaluate if the dose-dense therapy could improve clinical outcome. We performed a centralized immunohistochemical stains on formalin-fixed paraffin-embedded tissues from diagnostic biopsies with the following antibodies: CD10, bcl-6, bcl-2, MUM1 and Mib1. Based on the published algorithm we subdivided the pts in GCB and non-GCB origin. We evaluated also the prognostic value of single protein expression. Twenty-seven pts were male, 22 stage III-IV, 17 presented symptoms at diagnosis 22 showed abnormal LDH value, the IPI was intermediate-high risk or high risk in 13 pts. According to immunohistochemistry analysis 16 pts derived from GC and 24 from non-GC, 12 pts presented a positive CD10, 30 a positivity for bcl6, 19 a positive bcl2 and 27 a positive MUM1. Twenty-nine pts (73%) obtained a complete remission (CR), 8 a partial response (PR) and 3 were non responders (NR). Four out 29 CR pts experienced relapse, three (75%) derived from nonGC. Eight pts died, 4 derived from GC and 4 from non-GC. After a median period of observation of 18 months (range 3-72) the overall survival (OS) was 75% and the failure free survival (FFS) was 57%. The statistical analysis was performed comparing the B cell origin and clinical characteristics, moreover was also evaluated the expression of bcl2 either in GC or in non-GC lymphomas. In univariate analysis normal Beta2 microglobulin and low-intermediate risk IPI were significantly associated with longer overall survival. In univariate and multivariate analysis FFS was significantly higher in low and low-intermediate IPI risk pts. No differences were reported in OS and FFS evaluating the B cell origin. In conclusion we can point out that the intensification could enhance the efficacy of R-CHOP regimen improving the overall survival and FFS in pts with non-GC lymphoma. In this analysis the only significance was the IPI index that affected either OS or FFS.
RITUXIMAB-CHOP14 SEEMS TO OVERCOME THE NEGATIVE PROGNOSTIC SIGNIFICANCE OF B CELL ORIGIN IN DLBCL LYMPHOMA PATIENTS / B., Puccini; L., Rigacci; Martelli, Maurizio; S., di Lollo; V., Naso; M., Doria; E., Finolezzi; L., Nassi; R., Alterini; V., Carrai; A., Bosi. - In: HAEMATOLOGICA. - ISSN 0390-6078. - 93 (SUPPL. 2):(2008), pp. S106-S106. (Intervento presentato al convegno 10th Congress of the Italian-Society-of-Experimental-Hematology tenutosi a Bari, ITALY nel SEP 24-26, 2008).
RITUXIMAB-CHOP14 SEEMS TO OVERCOME THE NEGATIVE PROGNOSTIC SIGNIFICANCE OF B CELL ORIGIN IN DLBCL LYMPHOMA PATIENTS
MARTELLI, Maurizio;
2008
Abstract
Diffuse large B cell lymphoma (DLBCL) is the most common types of non-Hodgkin’s lympoma. Approximately half of all patients (pts) will be cured of their disease by primary therapy. Two major subgroups were identified by gene expression profiling: germinal centre B (GC) cell or non-germinal centre (non-GC). The GC group showes a significantly better survival than the non-GC group. Immunohistochemistry has been evaluated as a surrogate for this molecular classification. The aim of this study was to define retrospectively the B-cell origin of 40 pts treated with R-CHOP14 and to evaluate if the dose-dense therapy could improve clinical outcome. We performed a centralized immunohistochemical stains on formalin-fixed paraffin-embedded tissues from diagnostic biopsies with the following antibodies: CD10, bcl-6, bcl-2, MUM1 and Mib1. Based on the published algorithm we subdivided the pts in GCB and non-GCB origin. We evaluated also the prognostic value of single protein expression. Twenty-seven pts were male, 22 stage III-IV, 17 presented symptoms at diagnosis 22 showed abnormal LDH value, the IPI was intermediate-high risk or high risk in 13 pts. According to immunohistochemistry analysis 16 pts derived from GC and 24 from non-GC, 12 pts presented a positive CD10, 30 a positivity for bcl6, 19 a positive bcl2 and 27 a positive MUM1. Twenty-nine pts (73%) obtained a complete remission (CR), 8 a partial response (PR) and 3 were non responders (NR). Four out 29 CR pts experienced relapse, three (75%) derived from nonGC. Eight pts died, 4 derived from GC and 4 from non-GC. After a median period of observation of 18 months (range 3-72) the overall survival (OS) was 75% and the failure free survival (FFS) was 57%. The statistical analysis was performed comparing the B cell origin and clinical characteristics, moreover was also evaluated the expression of bcl2 either in GC or in non-GC lymphomas. In univariate analysis normal Beta2 microglobulin and low-intermediate risk IPI were significantly associated with longer overall survival. In univariate and multivariate analysis FFS was significantly higher in low and low-intermediate IPI risk pts. No differences were reported in OS and FFS evaluating the B cell origin. In conclusion we can point out that the intensification could enhance the efficacy of R-CHOP regimen improving the overall survival and FFS in pts with non-GC lymphoma. In this analysis the only significance was the IPI index that affected either OS or FFS.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
