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Liu Y, Han H, Wei H, Wang X, Luan Z, Jiang K. Predictive Modelling of Overall Survival in Adult Patients with Primary Diffuse Large B-cell Lymphoma of the Breast Using the Surveillance, Epidemiology, and End Results (SEER) Database. Recent Pat Anticancer Drug Discov 2024; 19:373-382. [PMID: 37464821 DOI: 10.2174/1574892818666230718153721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/25/2023] [Accepted: 06/13/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE We aimed to identify critical clinical features to develop an accurate webbased prediction model for estimating the overall survival (OS) of primary breast diffuse large Bcell lymphoma (PB-DLBCL) adult patients. METHODS We first included all PB-DLBCL cases with available covariates retrieved from the Surveillance, Epidemiology, and End Results database. We sequentially performed univariate and multivariate Cox regression approaches to identify the predictors independently associated with prognosis, and all the predictors that passed these tests were then constructed to build a nomogram for predicting 3-, 5-, and 10-year survival rates of patients. The C-index and the receiver operating characteristic curve (ROC) were used to evaluate the prediction discrimination, and the calibration curve was applied to estimate the calibration. RESULTS A total of PB-DLBCL adult patients were included (median age was 69 with the interquartile range [IQR] of 57-79 years), of which 466 (70%) were randomly allocated to the development cohort, and the remaining cases were collected for validation. Using three identified independent predictors (i.e., age, stage, and radiation), an accurate nomogram for predicting OS was developed and validated. The C-indices of our nomogram were both relatively acceptable, with 0.74 (95% CI: 0.71-0.78) and 0.72 (95% CI: 0.70-0.75) for the development and validation cohorts, respectively. The calibration curves also accurately predicted the prognosis of PB-DLBCL in all cases. In addition, ROC curves showed our nomogram to possess superior predictive ability compared to any single variable. To visually present this prediction model, a convenient webbased tool was implemented based on our prognostic nomogram. CONCLUSION For patients with PB-DLBCL, a more convenient and accurate web-based prediction model was developed and validated, which showed relatively good performances in both discrimination and calibration during model development and validation. External evaluation and validation are warranted by further independent studies.
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Affiliation(s)
- Yishuai Liu
- Department of Clinical Laboratory, Weifang Traditional Chinese Hospital, Weifang, China
| | - Haifeng Han
- Department of Clinical Laboratory, Weifang People's Hospital, Weifang, China
| | - Hong Wei
- Department of Clinical Laboratory, Weifang Traditional Chinese Hospital, Weifang, China
| | - Xinlong Wang
- Department of Clinical Laboratory, Weifang Traditional Chinese Hospital, Weifang, China
| | - Zhaotang Luan
- Department of Clinical Laboratory, Weifang Traditional Chinese Hospital, Weifang, China
| | - Kun Jiang
- Department of Clinical Laboratory, Weifang People's Hospital, Weifang, China
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Yang J, Li Y, Zhang Y, Fang X, Chen N, Zhou X, Wang X. Sirt6 promotes tumorigenesis and drug resistance of diffuse large B-cell lymphoma by mediating PI3K/Akt signaling. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2020; 39:142. [PMID: 32711549 PMCID: PMC7382040 DOI: 10.1186/s13046-020-01623-w] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 06/14/2020] [Indexed: 12/11/2022]
Abstract
Background Sirtuin 6 (Sirt6) is a highly conserved ADP-ribosylase and NAD+ dependent deacylase, involved in broad cellular processes. This molecule possesses contradictory roles in carcinogenesis, as it has been documented to both suppressing and augmenting tumor growth. This project aimed to explore the expression and functions of Sirt6 in diffuse large B-cell lymphoma (DLBCL), especially with regards to the regulatory role of OSS_128167, a novel small molecular inhibitor targeting Sirt6. Methods Immunohistochemistry (IHC) was conducted to assess the expression of Sirt6 on paraffin-embedded tissues. Microarray dataset GSE32918 and GSE83632 were obtained from Gene Expression Omnibus and survival analysis was performed. Lentivirus vectors either encoding shSirt6, lvSirt6 or empty lentiviral vector were stably transfected into DLBCL cells. LY1 cell transfected with shSirt6 were performed RNA-sequencing (RNA-seq) analysis, functional enrichment analyses of gene ontology (GO) and gene set enrichment analysis (GSEA). DLBCL cells were subcutaneously injected to SCID beige mice to establish xenograft models. Results Sirt6 is found to be overexpressed in DLBCL, and is related to poor prognosis. Sirt6-deprived DLBCL cells displayed augmented sensitivity towards chemotherapy, higher rates of apoptosis, dysfunctional cell proliferation, and arrested cell cycle progression between the G2 and M phases. Selective OSS_128167-mediated Sirt6 blockage resulted in similar anti-lymphoma effects when compared to Sirt6 knocked-down DLBCL cells. PI3K signaling along with phosphorylation of its downstream targets was reduced upon Sirt6 downregulation. Xenograft models subjected to either OSS_128167 treatment or Sirt6-knockdown showed suppressed tumor growth and lower Ki-67 level. Conclusions These findings provide mechanistic insights into the oncogenic activity of Sirt6 in DLBCL for the first time and highlighted the potency of OSS_128167 for novel therapeutic strategies in DLBCL.
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Affiliation(s)
- Juan Yang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong First Medical University, No.324 Jingwu Road, Jinan, 250021, Shandong, China.,School of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Ying Li
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong First Medical University, No.324 Jingwu Road, Jinan, 250021, Shandong, China
| | - Ya Zhang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong First Medical University, No.324 Jingwu Road, Jinan, 250021, Shandong, China
| | - Xiaosheng Fang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong First Medical University, No.324 Jingwu Road, Jinan, 250021, Shandong, China
| | - Na Chen
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong First Medical University, No.324 Jingwu Road, Jinan, 250021, Shandong, China
| | - Xiangxiang Zhou
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong First Medical University, No.324 Jingwu Road, Jinan, 250021, Shandong, China. .,National clinical research center for hematologic diseases, Jinan, 250021, Shandong, China.
| | - Xin Wang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong First Medical University, No.324 Jingwu Road, Jinan, 250021, Shandong, China. .,School of Medicine, Shandong University, Jinan, 250012, Shandong, China. .,Shandong Provincial Engineering Research Center of Lymphoma, Jinan, 250021, Shandong, China. .,National clinical research center for hematologic diseases, Jinan, 250021, Shandong, China.
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Chen LY, Zhang XM, Han BQ, Dai HB. Long Noncoding RNA SNHG12 Indicates the Prognosis and Accelerates Tumorigenesis of Diffuse Large B-Cell Lymphoma Through Sponging microR-195. Onco Targets Ther 2020; 13:5563-5574. [PMID: 32606771 PMCID: PMC7305849 DOI: 10.2147/ott.s249429] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 05/11/2020] [Indexed: 12/21/2022] Open
Abstract
Background Small nucleolar RNA host gene 12 (SNHG12) expression is associated with multiple cancers, including renal cell carcinoma, prostate cancer, cervical cancer, nasopharyngeal carcinoma, colorectal cancer, and hepatocellular carcinoma. However, SNHG12 biological function is unclear in diffuse large B-cell lymphoma (DLBCL). Methods SNHG12 expression and associated clinicopathological characteristics were evaluated in DLBCL tissues. CCK-8 and transwell assay were used to analyze the in vitro role of SNHG12 in DLBCL progression. The xenograft model was used to explore the in vivo role of SNHG12 in DLBCL growth. The physical interaction between SNHG12 and miR-195 was confirmed using bioinformatics analysis and a dual luciferase assay. Results SNHG12 expression was upregulated in DLBCL tissues and correlated with patients’ prognosis. SNHG12 downregulation inhibited cell growth, migration, and invasion of DLBCL cells in vitro, while its overexpression promoted these cellular processes. Moreover, SNHG12 knockdown repressed tumorigenesis of DLBCL cells in vivo. Further experiments demonstrated that miR-195 is a target of SNHG12 in DLBCL and that their expression negatively correlates in DLBCL. SNHG12 functioned as a competing endogenous RNA for miR-195 in DLBCL cells and miR-195 upregulation abolished the effects of SNHG12 on of DLBCL progression. Conclusion SNHG12 predicts poor clinical outcome and serves as a novel oncogene in DLBCL via miR-195 sponging. We also suggest that SNHG12 can be used as a potential therapeutic candidate for DLBCL patients.
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Affiliation(s)
- Li-Yan Chen
- Department of Hematology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, People's Republic of China
| | - Xiao-Min Zhang
- Department of Hematology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, People's Republic of China
| | - Bi-Qing Han
- Department of Hematology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, People's Republic of China
| | - Hai-Bin Dai
- Department of Hematology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, People's Republic of China
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Cheng H, Yan Z, Wang X, Cao J, Chen W, Qi K, Zhou D, Xia J, Qi N, Li Z, Xu K. Downregulation of long non-coding RNA TUG1 suppresses tumor growth by promoting ubiquitination of MET in diffuse large B-cell lymphoma. Mol Cell Biochem 2019; 461:47-56. [PMID: 31338678 DOI: 10.1007/s11010-019-03588-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 07/13/2019] [Indexed: 01/12/2023]
Abstract
Long non-coding RNAs (lncRNAs) can modulate gene expression through different mechanisms, but the fundamental molecular mechanism between lncRNAs and MET protein in diffuse large B-cell lymphoma (DLBCL) was poorly understood. The expression of lncRNA TUG1 and MET in DLBCL tissues and cell lines was determined by quantitative real-time PCR and western blotting. Cell proliferation, invasion and apoptosis were determined by cell counting kit-8 assay, transwell assay and flow cytometer. The animal xenograft model was established by the injection of DLBCL cells carrying si-TUG1. The expression of TUG1 and MET was upregulated in DLBCL tissues and cells. We demonstrated that MET was altered in the TUG1 knockdown DLBCL cells, and confirmed the interaction between TUG1 and MET by RNA pull-down and RNA immunoprecipitation. Furthermore, knockdown of TUG1 reduced MET protein level by promoting ubiquitination, and suppressed tumor growth in vitro and in vivo. Our findings demonstrated that TUG1 exerted its oncogenic function in DLBCL by inhibiting the ubiquitination and the subsequent degradation of MET. Knockdown of TUG1 through MET downregulation suppressed DLBCL cell proliferation and tumor growth.
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MESH Headings
- Animals
- Apoptosis/genetics
- Cell Line, Tumor
- Cell Proliferation/genetics
- Down-Regulation/genetics
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Mice, Inbred BALB C
- Mice, Nude
- Middle Aged
- Proto-Oncogene Proteins c-met/genetics
- Proto-Oncogene Proteins c-met/metabolism
- RNA, Long Noncoding/genetics
- RNA, Long Noncoding/metabolism
- Ubiquitination/genetics
- Up-Regulation/genetics
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Hai Cheng
- Blood Diseases Institute, Xuzhou Medical University, Department of Hematology, Key Laboratory of Bone Marrow Stem Cell, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Quanshan District, Xuzhou, 221000, Jiangsu, China
| | - Zhiling Yan
- Blood Diseases Institute, Xuzhou Medical University, Department of Hematology, Key Laboratory of Bone Marrow Stem Cell, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Quanshan District, Xuzhou, 221000, Jiangsu, China
| | - Xue Wang
- Blood Diseases Institute, Xuzhou Medical University, Department of Hematology, Key Laboratory of Bone Marrow Stem Cell, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Quanshan District, Xuzhou, 221000, Jiangsu, China
| | - Jiang Cao
- Blood Diseases Institute, Xuzhou Medical University, Department of Hematology, Key Laboratory of Bone Marrow Stem Cell, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Quanshan District, Xuzhou, 221000, Jiangsu, China
| | - Wei Chen
- Blood Diseases Institute, Xuzhou Medical University, Department of Hematology, Key Laboratory of Bone Marrow Stem Cell, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Quanshan District, Xuzhou, 221000, Jiangsu, China
| | - Kunming Qi
- Blood Diseases Institute, Xuzhou Medical University, Department of Hematology, Key Laboratory of Bone Marrow Stem Cell, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Quanshan District, Xuzhou, 221000, Jiangsu, China
| | - Dian Zhou
- Blood Diseases Institute, Xuzhou Medical University, Department of Hematology, Key Laboratory of Bone Marrow Stem Cell, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Quanshan District, Xuzhou, 221000, Jiangsu, China
| | - Jieyun Xia
- Blood Diseases Institute, Xuzhou Medical University, Department of Hematology, Key Laboratory of Bone Marrow Stem Cell, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Quanshan District, Xuzhou, 221000, Jiangsu, China
| | - Na Qi
- Blood Diseases Institute, Xuzhou Medical University, Department of Hematology, Key Laboratory of Bone Marrow Stem Cell, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Quanshan District, Xuzhou, 221000, Jiangsu, China
| | - Zhenyu Li
- Blood Diseases Institute, Xuzhou Medical University, Department of Hematology, Key Laboratory of Bone Marrow Stem Cell, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Quanshan District, Xuzhou, 221000, Jiangsu, China
| | - Kailin Xu
- Blood Diseases Institute, Xuzhou Medical University, Department of Hematology, Key Laboratory of Bone Marrow Stem Cell, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Quanshan District, Xuzhou, 221000, Jiangsu, China.
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Zhong HJ, Xu PP, Zhao WL. [Efficacy of additional two cycles of rituximab administration for patients with diffuse large B-cell lymphoma in first remission]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2018; 37:756-761. [PMID: 27719717 PMCID: PMC7342108 DOI: 10.3760/cma.j.issn.0253-2727.2016.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the efficacy of additional two cycles of rituximab administration for Chinese patients with diffuse large B-cell lymphoma (DLBCL) in first complete remission (CR) after six cycles of standard 21-day rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP21). Methods: Retrospective analysis was performed in 351 patients with DLBCL diagnosed from March 2003 to March 2012. International Prognosis Index (IPI), Revised (R)-IPI and National Comprehensive Cancer Network (NCCN)-IPI were calculated for each patient. Patients were divided into GCB and non-GCB subtype according to Han's Classification. Progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier methods. Results: 282 (80.3%) patients achieved CR and 132 (46.8%) of 282 cases received additional two rituximab therapy. The other 150 (53.2%) patients entered into observation on the intention of the patients. No significant difference was observed in baseline characteristics between the two groups. 3-year estimated PFS for additional rituximab group and observation group were 80.0% and 78.1% (P=0.334), while 3-year estimated OS were 89.7% vs. 86.1% (P=0.452). By subgroup analysis, prolonged PFS were observed in R-IPI low-risk and NCCN-IPI low-risk patients after additional two rituximab cycles. Conclusion: For patients with DLBCL in first remission after standard six cycles of R-CHOP21 regimen, additional two cycles of rituximab maintenance did not significantly improve the general prognosis, but low-risk subgroups of R-IPI and NCCN-IPI could benefit from this regimen.
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Affiliation(s)
- H J Zhong
- Department of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Liu PP, Wang KF, Jin JT, Bi XW, Sun P, Wang Y, Yang H, Li ZM, Jiang WQ, Xia Y. Role of radiation therapy in primary breast diffuse large B-cell lymphoma in the Rituximab era: a SEER database analysis. Cancer Med 2018; 7:1845-1851. [PMID: 29624913 PMCID: PMC5943465 DOI: 10.1002/cam4.1457] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 02/23/2018] [Accepted: 02/28/2018] [Indexed: 11/08/2022] Open
Abstract
Primary breast diffuse large B-cell lymphoma (PB-DLBCL) is an uncommon extranodal non-Hodgkin's lymphoma (NHL), which was traditionally treated with anthracycline-containing regimens followed by consolidative radiation therapy (RT) to add therapeutic benefits. The introduction of anti-CD20 antibody rituximab for the treatment of B-cell NHLs has significantly improved the clinical outcome of these malignant diseases. It is unclear, however, whether consolidative RT could still add therapeutic benefits for PB-DLBCL patients treated with rituximab. To answer this important question, we used the Surveillance, Epidemiology, and End Results (SEER) database to evaluate the impact of RT on the clinical outcomes of PB-DLBCL patients in the rituximab era. Information on patient age, year of diagnosis, stage, race, laterality, and RT status for PB-DLBCL patients diagnosed between 2001 and 2014 were extracted. Kaplan-Meier survival curves were plotted, and log-rank test was used to compare the potential survival difference. Multivariate analysis using Cox proportional hazards model was employed to determine the impact of RT and other factors such as age, race, tumor laterality, stage, and year of diagnosis on survival. Among the 386 patients identified, the median follow-up time was 45 months (range, 0-167 months); the median age was 64 years (range, 19-93 years); 33.9% of the patients were younger than 60 years of age; 69.9% of the patients were stage I; 79.0% were white; 51.8% received RT. The 5-year OS and cause-specific survival (CSS) for the whole cohort were 72.3% and 82.5%, respectively. The 5-year OS was significantly superior for patients who received RT compared to those who did not receive RT (78.1% vs. 66.0%, P = 0.031). In multivariable analysis, RT remained significantly associated with improved OS (P = 0.026). In summary, our study suggests that RT still adds significant therapeutic benefits for patients with PB-DLCBL in the rituximab era.
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Affiliation(s)
- Pan-Pan Liu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dong Feng East Road, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
| | - Ke-Feng Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dong Feng East Road, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
| | - Jie-Tian Jin
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China.,Department of Thoracic Surgery, The Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, 510120, China
| | - Xi-Wen Bi
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dong Feng East Road, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
| | - Peng Sun
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dong Feng East Road, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
| | - Yu Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dong Feng East Road, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
| | - Hang Yang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dong Feng East Road, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
| | - Zhi-Ming Li
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dong Feng East Road, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
| | - Wen-Qi Jiang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dong Feng East Road, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
| | - Yi Xia
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dong Feng East Road, Guangzhou, Guangdong, 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, China
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Zhou X, Fang X, Jiang Y, Geng L, Li X, Li Y, Lu K, Li P, Lv X, Wang X. Klotho, an anti-aging gene, acts as a tumor suppressor and inhibitor of IGF-1R signaling in diffuse large B cell lymphoma. J Hematol Oncol 2017; 10:37. [PMID: 28153033 PMCID: PMC5288890 DOI: 10.1186/s13045-017-0391-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 01/03/2017] [Indexed: 01/13/2023] Open
Abstract
Background Klotho, is a transmembrane protein, performs as a circulating hormone and upstream modulator of the insulin-like growth factor-1 receptor (IGF-1R), fibroblast growth factor (FGF), and Wnt signaling pathways. These pathways are involved in the development and progression of B cell lymphoma. We aimed to explore the expression pattern and functional mechanism of Klotho in diffuse large B cell lymphoma (DLBCL). Methods Immunohistochemistry (IHC) and western blotting were performed to detect the expression level of Klotho in DLBCL patients and cell lines. Tumor suppressive effect of Klotho was determined by both in vitro and in vivo studies. Signaling pathway activity was assessed by western blotting. Results Remarkable lower expression levels of Klotho were observed in DLBCL patients and cell lines. Enforced expression of Klotho could significantly induce cell apoptosis and inhibit tumor growth in DLBCL. Upregulation of Klotho resulted in declined activation of IGF-1R signaling, accompanied with decreased phosphorylation of its downstream targets, including AKT and ERK1/2. Moreover, xenograft model treated with either Klotho overexpression vector or recombinant human Klotho administration presented restrained tumor growth and lower Ki67 staining. Conclusions Our findings establish that Klotho performs as a tumor suppressor and modulator of IGF-1R signaling in DLBCL. Targeting Klotho may provide novel strategies for future therapeutic intervention.
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Affiliation(s)
- Xiangxiang Zhou
- Department of Hematology, Shandong Provincial Hospital affiliated to Shandong University, No.324, Jingwu Road, Jinan, Shandong, 250021, People's Republic of China
| | - Xiaosheng Fang
- Department of Hematology, Shandong Provincial Hospital affiliated to Shandong University, No.324, Jingwu Road, Jinan, Shandong, 250021, People's Republic of China
| | - Yujie Jiang
- Department of Hematology, Shandong Provincial Hospital affiliated to Shandong University, No.324, Jingwu Road, Jinan, Shandong, 250021, People's Republic of China
| | - Lingyun Geng
- Department of Hematology, Shandong Provincial Hospital affiliated to Shandong University, No.324, Jingwu Road, Jinan, Shandong, 250021, People's Republic of China
| | - Xinyu Li
- Department of Hematology, Shandong Provincial Hospital affiliated to Shandong University, No.324, Jingwu Road, Jinan, Shandong, 250021, People's Republic of China
| | - Ying Li
- Department of Hematology, Shandong Provincial Hospital affiliated to Shandong University, No.324, Jingwu Road, Jinan, Shandong, 250021, People's Republic of China
| | - Kang Lu
- Department of Hematology, Shandong Provincial Hospital affiliated to Shandong University, No.324, Jingwu Road, Jinan, Shandong, 250021, People's Republic of China
| | - Peipei Li
- Department of Hematology, Shandong Provincial Hospital affiliated to Shandong University, No.324, Jingwu Road, Jinan, Shandong, 250021, People's Republic of China
| | - Xiao Lv
- Department of Hematology, Shandong Provincial Hospital affiliated to Shandong University, No.324, Jingwu Road, Jinan, Shandong, 250021, People's Republic of China
| | - Xin Wang
- Department of Hematology, Shandong Provincial Hospital affiliated to Shandong University, No.324, Jingwu Road, Jinan, Shandong, 250021, People's Republic of China. .,Shandong University School of Medicine, Jinan, Shandong, 250012, People's Republic of China.
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8
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Witzens-Harig M, Benner A, McClanahan F, Klemmer J, Brandt J, Brants E, Rieger M, Meissner J, Hensel M, Neben K, Dreger P, Lengfelder E, Schmidt-Wolf I, Krämer A, Ho AD. Rituximab maintenance improves survival in male patients with diffuse large B-cell lymphoma. Results of the HD2002 prospective multicentre randomized phase III trial. Br J Haematol 2015; 171:710-9. [PMID: 26449739 DOI: 10.1111/bjh.13652] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 07/22/2015] [Indexed: 11/30/2022]
Abstract
In the multicentre prospective randomized HD2002 trial, rituximab maintenance therapy (375 mg/m(2) every 3 months for 2 years) versus observation was evaluated for CD20(+) B-cell lymphoma. Out of 321 patients [161 randomized to the treatment group (TG), 160 to the observation group (OG)], 295 data sets were evaluable for statistical analysis. Estimated 5-year relapse-free survival (RFS) was 81% in the TG and 70% in the OG (logrank test, P = 0·047). In the diffuse large B-cell lymphoma (DLBCL) subgroup (n = 152), 5-year RFS was excellent, at 87% in the TG and 84% in the OG (logrank test, P = 0·35). Of note, only in male patients of the DLBCL subgroup was RFS significantly superior in the TG in comparison to the OG (5-year RFS: 88% vs. 74%; logrank test, P = 0·05). Cox regression analysis showed a significant interaction between treatment and gender regarding overall survival (OS) (P = 0·006) and RFS (P = 0·02), with a lower hazard in females than males in the OG [OS: hazard ratio (HR) (female:male) = 0·11; 95% confidence interval (CI) = 0·00-1·03; RFS: HR (female:male) = 0·27; 95% CI = 0·05-0·97], and no significant differences between males and females in the TG. We conclude that Rituximab maintenance therapy improves survival in male patients with DLBCL.
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Affiliation(s)
| | - Axel Benner
- Division of Biostatistics, German Cancer Research Centre, Heidelberg, Germany
| | - Fabienne McClanahan
- Centre for Haemato-Oncology, Barts Cancer Institute - a CR-UK Centre of Excellence, London, UK
| | - Jennifer Klemmer
- Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Julia Brandt
- Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Elke Brants
- Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Michael Rieger
- Onkologische Schwerpunktpraxis Darmstadt, Darmstadt, Germany
| | - Julia Meissner
- Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | | | - Kai Neben
- Klinikum Mittelbaden, Baden-Baden, Germany
| | - Peter Dreger
- Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Eva Lengfelder
- Haematology and Oncology, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Ingo Schmidt-Wolf
- Department of Medicine III, Centre for Integrated Oncology (CIO), University of Bonn, Bonn, Germany
| | - Alwin Krämer
- Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Anthony D Ho
- Internal Medicine V, University of Heidelberg, Heidelberg, Germany
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Hao X, Wei X, Huang F, Wei Y, Zeng H, Xu L, Zhou Q, Feng R. The expression of CD30 based on immunohistochemistry predicts inferior outcome in patients with diffuse large B-cell lymphoma. PLoS One 2015; 10:e0126615. [PMID: 25974110 PMCID: PMC4431801 DOI: 10.1371/journal.pone.0126615] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 04/04/2015] [Indexed: 12/11/2022] Open
Abstract
The prognostic value of CD30 expression indiffuse large B-cell lymphoma (DLBCL)remains controversial. Herein, we performed this retrospective study to investigate the clinical and prognostic significance of CD30 expression in patients with DLBCL.Among all the 146 patients, the expression of CD30 was observed in 23 cases (15.7%).The DLBCL patients with CD30 expression showed more likely to present B symptoms, bone marrow involvement, non-germinal centre B-cell-like (Non-GCB) DLBCL, BCL-2 and Ki-67overexpression(p<0.05). Patients with CD30 expression showed significantly poor overall and event-free survivalcompared with CD30 negative patients(p = 0.031 and 0.041, respectively), especially those with the high intermediate/high-risk international prognostic index (IPI)(p = 0.001 and 0.007, respectively). The prognostic value of CD30expression retained in DLBCL patients treated with eitherCHOP (cyclophosphamide, doxorubicin, vincristine,prednisone) or R-CHOP(rituximab+CHOP). The multivariate analysisrevealed that the expression of CD30 remained an unfavorable factor for both overall and event-free survival (p = 0.001 and 0.002, respectively).In conclusion, these data suggest that CD30 is expressed predominantly in Non-GCBDLBCL. The expression of CD30 implied poor outcomein DLBCL patientstreated with either CHOP or R-CHOP, especially those with the high intermediate/high-risk IPI, possibly indicating that anti-CD30 monoclonal antibody could be of clinical interest.
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Affiliation(s)
- Xiaoxiao Hao
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaolei Wei
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Fen Huang
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yongqiang Wei
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hong Zeng
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Linwei Xu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qinjun Zhou
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ru Feng
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- * E-mail:
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Song MK, Chung JS, Lee GW, Cho SH, Hong J, Shin DY, Shin HJ. Statin use has negative clinical impact on non-germinal center in patients with diffuse large B cell lymphoma in rituximab era. Leuk Res 2015; 39:211-5. [DOI: 10.1016/j.leukres.2014.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 11/21/2014] [Accepted: 12/02/2014] [Indexed: 01/27/2023]
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11
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Shin HC, Seo J, Kang BW, Moon JH, Chae YS, Lee SJ, Lee YJ, Han S, Seo SK, Kim JG, Sohn SK, Park TI. Clinical significance of nuclear factor κB and chemokine receptor CXCR4 expression in patients with diffuse large B-cell lymphoma who received rituximab-based therapy. Korean J Intern Med 2014; 29:785-92. [PMID: 25378977 PMCID: PMC4219968 DOI: 10.3904/kjim.2014.29.6.785] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Revised: 08/20/2013] [Accepted: 01/06/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND/AIMS This study investigated the expression of nuclear factor κB (NF-κB) and the chemokine receptor (CXCR4) in patients with diffuse large B-cell lymphoma (DLBCL) who received rituximab-based therapy. METHODS Seventy patients with DLBCL and treated with rituximab-CHOP (R-CHOP) were included, and immunohistochemistry was performed to determine the expression of NF-κB (IκB kinase α, p50, and p100/p52) and CXCR4. To classify DLBCL cases as germinal center B-cell-like (GCB) and non-GCB, additional immunohistochemical expression of CD10, bcl-6, or MUM1 was used in this study. The expression was divided into two groups according to the intensity score (negative, 0 or 1+; positive, 2+ or 3+). RESULTS The median age of the patients was 66 years (range, 17 to 87), and 58.6% were male. Twenty-seven patients (38.6%) had stage III or IV disease at diagnosis. Twenty-three patients (32.9%) were categorized as high or high-intermediate risk according to their International Prognostic Indexs (IPIs). The overall incidence of bone marrow involvement was 5.7%. Rates of positive NF-κB and CXCR4 expression were 84.2% and 88.6%, respectively. High NF-κB expression was associated with CXCR4 expression (p = 0.002), and 56 patients (80.0%) showed coexpression. However, the expression of NF-κB or CXCR4 was not associated with overall survival and EFS. On multivariate analysis that included age, gender, performance status, stage, and the IPI, no significant association between the grade of NF-κB or CXCR4 expression and survival was observed. CONCLUSIONS The current study suggests that the tissue expression of NF-κB and CXCR4 may not be an independent prognostic marker in DLBCL patients treated with R-CHOP.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/analysis
- Chi-Square Distribution
- Cyclophosphamide/administration & dosage
- Disease Progression
- Disease-Free Survival
- Doxorubicin/administration & dosage
- Female
- Humans
- Immunohistochemistry
- Kaplan-Meier Estimate
- Lymphoma, Large B-Cell, Diffuse/chemistry
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Middle Aged
- Multivariate Analysis
- NF-kappa B/analysis
- Neoplasm Staging
- Predictive Value of Tests
- Prednisone/administration & dosage
- Proportional Hazards Models
- Receptors, CXCR4/analysis
- Retrospective Studies
- Risk Factors
- Rituximab
- Time Factors
- Treatment Outcome
- Vincristine/administration & dosage
- Young Adult
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Affiliation(s)
- Ho Cheol Shin
- Department of Hematology and Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Jongwon Seo
- Department of Hematology and Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Byung Woog Kang
- Department of Hematology and Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Joon Ho Moon
- Department of Hematology and Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Yee Soo Chae
- Department of Hematology and Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Soo Jung Lee
- Department of Hematology and Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Yoo Jin Lee
- Department of Hematology and Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Seoae Han
- Department of Hematology and Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Sang Kyung Seo
- Department of Hematology and Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Jong Gwang Kim
- Department of Hematology and Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Sang Kyun Sohn
- Department of Hematology and Oncology, Kyungpook National University Hospital, Daegu, Korea
| | - Tae-In Park
- Department of Pathology, Kyungpook National University Hospital, Daegu, Korea
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Kim JK, Chung JS, Shin HJ, Song MK, Yi JW, Shin DH, Lee DS, Baek SM. Influence of NK cell count on the survival of patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood Res 2014; 49:162-9. [PMID: 25325035 PMCID: PMC4188781 DOI: 10.5045/br.2014.49.3.162] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 06/13/2014] [Accepted: 07/23/2014] [Indexed: 12/22/2022] Open
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/µL) 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.
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Affiliation(s)
- Joong-Keun Kim
- Department of Hematology-Oncology, Pusan National University Hospital Medical Research Institute, Busan, Korea
| | - Joo-Seop Chung
- Department of Hematology-Oncology, Pusan National University Hospital Medical Research Institute, Busan, Korea
| | - Ho-Jin Shin
- Department of Hematology-Oncology, Pusan National University Hospital Medical Research Institute, Busan, Korea
| | - Moo-Kon Song
- Department of Hematology-Oncology, Pusan National University Hospital Medical Research Institute, Busan, Korea
| | - Ji-Won Yi
- Department of Hematology-Oncology, Pusan National University Hospital Medical Research Institute, Busan, Korea
| | - Dong-Hun Shin
- Department of Hematology-Oncology, Pusan National University Hospital Medical Research Institute, Busan, Korea
| | - Dae-Sung Lee
- Department of Hematology-Oncology, Pusan National University Hospital Medical Research Institute, Busan, Korea
| | - Sung-Min Baek
- Department of Hematology-Oncology, Pusan National University Hospital Medical Research Institute, Busan, Korea
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Wei X, Huang F, Wei Y, Jing H, Xie M, Hao X, Feng R. Low lymphocyte-to-monocyte ratio predicts unfavorable prognosis in non-germinal center type diffuse large B-cell lymphoma. Leuk Res 2014; 38:694-8. [DOI: 10.1016/j.leukres.2014.03.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 03/09/2014] [Accepted: 03/16/2014] [Indexed: 01/01/2023]
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14
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Goto N, Tsurumi H, Takemura M, Matsumoto T, Shibata Y, Mabuchi R, Nakamura N, Nakamura H, Yamada T, Seishima M, Takami T, Takeuchi T, Moriwaki H. Serum Soluble Tumor Necrosis Factor Receptor 1 Level is Associated with the Outcome of Diffuse Large B-Cell Lymphoma Patients Treated with the CHOP or R-CHOP Regimen. J Clin Exp Hematop 2014; 54:117-27. [DOI: 10.3960/jslrt.54.117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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15
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Nakamura N, Goto N, Tsurumi H, Takemura M, Kanemura N, Kasahara S, Hara T, Yasuda I, Shimizu M, Sawada M, Yamada T, Seishima M, Takami T, Moriwaki H. Serum level of soluble tumor necrosis factor receptor 2 is associated with the outcome of patients with diffuse large B-cell lymphoma treated with the R-CHOP regimen. Eur J Haematol 2013; 91:322-31. [PMID: 23672298 DOI: 10.1111/ejh.12139] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Serum soluble tumor necrosis factor receptor 2 (sTNFR2) concentration predicted the clinical outcome of patients with aggressive non-Hodgkin's lymphoma including diffuse large B-cell lymphoma (DLBCL) treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) in our previous study. However, after rituximab (R) was introduced in clinical practice, R-CHOP replaced CHOP as the standard therapy for DLBCL. PATIENTS AND METHODS In this study, we re-evaluated the prognostic significance of serum sTNFR2 in 154 patients with DLBCL treated with R-CHOP. RESULTS Five-yr overall survival (5-yr OS) rates with sTNFR2 ≥20 ng/mL and <20 ng/mL were 29.2% and 83.3% (P < 0.0001), respectively, and the corresponding 5-yr progression-free survival (5-yr PFS) rates were 26.9% and 76.4% (P < 0.0001), respectively. A multivariate analysis revealed that serum sTNFR2 and complete remission (CR) were independent prognostic factors for both OS (CR: P < 0.0001, sTNFR2: P = 0.0001) and PFS (CR: P < 0.0001, sTNFR2: P = 0.0001). The prognosis of patients with poor risk groups according to the revised International Prognostic Index who also had high serum sTNFR2 was especially poor. CONCLUSION Serum sTNFR2 might be a powerful prognostic factor for patients with DLBCL in the rituximab era.
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Affiliation(s)
- Nobuhiko Nakamura
- First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
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Abstract
Diffuse large B cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma in all countries and all age groups. DLBCL is potentially curable, and the outcome of patients with DLBCL has completely changed with the introduction of therapy involving the monoclonal antibody rituximab in combination with chemotherapy. Nonetheless, relapse is detected after treatment with rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisolone in approximately 30% of patients. It has recently become clear that DLBCL represents a heterogeneous admixture of quite different entities. Gene expression profiling has uncovered DLBCL subtypes that have distinct clinical behaviors and prognoses; however, incorporation of this information into treatment algorithms awaits further investigation. Future approaches to DLBCL treatment will use this new genetic information to identify potential biomarkers for prognosis and targets for treatment.
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Affiliation(s)
- Jae-Yong Kwak
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
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T-cell immunotherapy with a chimeric receptor against CD38 is effective in eradicating chemotherapy-resistant B-cell lymphoma cells overexpressing survivin induced by BMI-1. Blood Cancer J 2012; 2:e75. [PMID: 22829977 PMCID: PMC3389163 DOI: 10.1038/bcj.2012.21] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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Goto N, Tsurumi H, Takemura M, Kanemura N, Kasahara S, Hara T, Yasuda I, Shimizu M, Yamada T, Sawada M, Takahashi T, Yamada T, Seishima M, Moriwaki H, Takami T. Serum soluble CD27 level is associated with outcome in patients with diffuse large B-cell lymphoma treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone. Leuk Lymphoma 2012; 53:1494-500. [DOI: 10.3109/10428194.2012.660627] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Serum soluble interleukin-2 receptor (sIL-2R) level is associated with the outcome of patients with diffuse large B cell lymphoma treated with R-CHOP regimens. Ann Hematol 2011; 91:705-714. [PMID: 22183251 DOI: 10.1007/s00277-011-1363-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Accepted: 10/26/2011] [Indexed: 10/14/2022]
Abstract
Serum concentration of soluble interleukin-2 receptor (sIL-2R) predicts the clinical outcome of patients with aggressive non-Hodgkin's lymphoma treated with the cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) regimen without rituximab. In the present study, we aim to re-assess the prognostic significance of serum sIL-2R for diffuse large B cell lymphoma (DLBCL) patients treated with CHOP plus rituximab and to assess sIL-2R with subtype of DLBCL, such as GCB type and non-GCB type. Two hundred and thirty-three patients with DLBCL were enrolled between December 2002 and March 2008. To evaluate serum levels of sIL-2R, venous blood samples were drawn from patients immediately before initiation of treatment. Serum sIL-2R was determined by sandwich enzyme-linked immunosorbent assay. The 5-year overall survival (OS) rates for patients with sIL-2R levels of ≥2,000 (110 cases) and <2,000 U/mL (123 cases) were 54.2% and 89.0% (P < 0.0001), respectively. Multivariate analysis using the proportional-hazards model revealed that serum sIL-2R (P = 0.0099) and extranodal involvement sites (P = 0.0392) were independent prognostic factors for OS and that clinical stage (P = 0.0168), performance status (P = 0.0181), sIL-2R (P = 0.0232), and LDH (P = 0.0316) were independent prognostic factors for progression-free survival in sIL-2R and every factor of the International Prognostic Index. Serum sIL-2R might be a useful prognostic factor for DLBCL patients in the rituximab era.
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Yhim HY, Kim JS, Kang HJ, Kim SJ, Kim WS, Choi CW, Eom HS, Kim JA, Lee JH, Won JH, Shim H, Huh J, Lee DH, Suh C, Kwak JY. Matched-pair analysis comparing the outcomes of primary breast and nodal diffuse large B-cell lymphoma in patients treated with rituximab plus chemotherapy. Int J Cancer 2011; 131:235-43. [DOI: 10.1002/ijc.26352] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2011] [Accepted: 07/29/2011] [Indexed: 11/11/2022]
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21
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Goto N, Tsurumi H, Kasahara S, Kanemura N, Hara T, Yasuda I, Shimizu M, Murakami N, Sawada M, Yamada T, Takemura M, Seishima M, Kito Y, Takami T, Moriwaki H. Serum interleukin-18 level is associated with the outcome of patients with diffuse large B-cell lymphoma treated with CHOP or R-CHOP regimens. Eur J Haematol 2011; 87:217-27. [DOI: 10.1111/j.1600-0609.2011.01649.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hong J, Park S, Park J, Kim HS, Kim KH, Ahn JY, Rim MY, Jung M, Sym SJ, Cho EK, Shin DB, Lee JH. Evaluation of prognostic values of clinical and histopathologic characteristics in diffuse large B-cell lymphoma treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone therapy. Leuk Lymphoma 2011; 52:1904-12. [DOI: 10.3109/10428194.2011.588761] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Okur FV, Krance R. Stem cell transplantation in childhood non-Hodgkin's lymphomas. Curr Hematol Malig Rep 2011; 5:192-9. [PMID: 20661786 DOI: 10.1007/s11899-010-0059-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Despite the high cure rates achieved with intensified primary therapies for childhood non-Hodgkin's lymphomas (NHL), the prognosis for children with relapsed or refractory disease is poor. Optimal treatment for this group remains a challenge. Dose intensification followed by stem cell transplantation has been used in these circumstances and may provide a curative treatment option for these patients, but the number of children treated using this approach is relatively small and its effectiveness has been difficult to judge. Moreover, the limited experience is insufficient to define the patient most likely to benefit from transplantation. Likewise, the selection of autologous or allogeneic transplantation and the optimal conditioning regimen are debated. We summarize the current experience for stem cell transplantation in childhood NHL and offer our recommendations.
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Affiliation(s)
- Fatma V Okur
- Texas Children's Cancer Center, Houston, TX 77030, USA.
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A systematic review and meta-analysis of rituximab-based immunochemotherapy for subtypes of diffuse large B cell lymphoma. Ann Hematol 2010; 89:1107-13. [DOI: 10.1007/s00277-010-0990-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Accepted: 05/07/2010] [Indexed: 02/08/2023]
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Rituximab in combination with CHOP chemotherapy for the treatment of diffuse large B cell lymphoma in Japan: a retrospective analysis of 1,057 cases from Kyushu Lymphoma Study Group. Int J Hematol 2010; 91:258-66. [DOI: 10.1007/s12185-009-0475-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Revised: 11/02/2009] [Accepted: 12/15/2009] [Indexed: 11/24/2022]
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Copie-Bergman C, Gaulard P, Leroy K, Briere J, Baia M, Jais JP, Salles GA, Berger F, Haioun C, Tilly H, Emile JF, Banham AH, Mounier N, Gisselbrecht C, Feugier P, Coiffier B, Molina TJ. Immuno–Fluorescence In Situ Hybridization Index Predicts Survival in Patients With Diffuse Large B-Cell Lymphoma Treated With R-CHOP: A GELA Study. J Clin Oncol 2009; 27:5573-9. [DOI: 10.1200/jco.2009.22.7058] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To evaluate the prognostic value of cell of origin immunohistochemical markers and BCL2, BCL6, and c-MYC translocations in a homogeneous cohort of patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Patients and Methods Patients with CD20+ DLBCL were enrolled in the randomized LNH98-5 and 01-5B Groupe d'Etude des Lymphomes de l'Adulte trials. Paraffin-embedded tumor samples of 119 patients treated with R-CHOP were analyzed by immunohistochemistry for CD10, BCL6, MUM1/IRF4, LMO2, and forkhead box protein P1 (FOXP1) expression and for BCL2, BCL6, and c-MYC breakpoints by fluorescence in situ hybridization (FISH) on tissue microarray. Results LMO2 expression and BCL2 breakpoint were associated with the germinal center (GC) subtype defined by Hans' algorithm, respectively (P < .0001; P = .0002) whereas FOXP1 expression and BCL6 breakpoint were associated with the non-germinal center (non-GC) subtype (P = .008 and P = .0001, respectively). The immunohistochemical markers analyzed independently, GC/non-GC phenotype and BCL2 breakpoint did not predict overall survival (OS). BCL6 breakpoint was significantly associated with an unfavorable impact on OS (P = .04). Interestingly, an immunoFISH index, defined by positivity for at least two of three non-GC markers (FOXP1, MUM1/IRF4, BCL6 breakpoint) was significantly associated with a shorter 5-year OS rate (44%; 95% CI, 28 to 60 v 78%; 95% CI, 59 to 89; P = .01) which was independent (P = .04) of the age-adjusted International Prognostic Index (P = .04) in multivariate analysis. Conclusion Our study demonstrates that combining immunohistochemistry with FISH allows construction of an immunoFISH index that significantly predicts survival in elderly DLBCL patients treated with R-CHOP.
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Affiliation(s)
- Christiane Copie-Bergman
- From the Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier; L'Institut National de la Santé et de la Recherche Médicale, Unité 955, Institut Mondor de Recherche Biomédicale; Université Paris 12, Faculté de médecine, Créteil; Université Paris Diderot and Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Necker; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu,
| | - Philippe Gaulard
- From the Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier; L'Institut National de la Santé et de la Recherche Médicale, Unité 955, Institut Mondor de Recherche Biomédicale; Université Paris 12, Faculté de médecine, Créteil; Université Paris Diderot and Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Necker; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu,
| | - Karen Leroy
- From the Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier; L'Institut National de la Santé et de la Recherche Médicale, Unité 955, Institut Mondor de Recherche Biomédicale; Université Paris 12, Faculté de médecine, Créteil; Université Paris Diderot and Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Necker; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu,
| | - Josette Briere
- From the Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier; L'Institut National de la Santé et de la Recherche Médicale, Unité 955, Institut Mondor de Recherche Biomédicale; Université Paris 12, Faculté de médecine, Créteil; Université Paris Diderot and Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Necker; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu,
| | - Maryse Baia
- From the Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier; L'Institut National de la Santé et de la Recherche Médicale, Unité 955, Institut Mondor de Recherche Biomédicale; Université Paris 12, Faculté de médecine, Créteil; Université Paris Diderot and Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Necker; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu,
| | - Jean-Philippe Jais
- From the Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier; L'Institut National de la Santé et de la Recherche Médicale, Unité 955, Institut Mondor de Recherche Biomédicale; Université Paris 12, Faculté de médecine, Créteil; Université Paris Diderot and Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Necker; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu,
| | - Gilles A. Salles
- From the Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier; L'Institut National de la Santé et de la Recherche Médicale, Unité 955, Institut Mondor de Recherche Biomédicale; Université Paris 12, Faculté de médecine, Créteil; Université Paris Diderot and Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Necker; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu,
| | - Françoise Berger
- From the Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier; L'Institut National de la Santé et de la Recherche Médicale, Unité 955, Institut Mondor de Recherche Biomédicale; Université Paris 12, Faculté de médecine, Créteil; Université Paris Diderot and Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Necker; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu,
| | - Corinne Haioun
- From the Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier; L'Institut National de la Santé et de la Recherche Médicale, Unité 955, Institut Mondor de Recherche Biomédicale; Université Paris 12, Faculté de médecine, Créteil; Université Paris Diderot and Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Necker; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu,
| | - Herve Tilly
- From the Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier; L'Institut National de la Santé et de la Recherche Médicale, Unité 955, Institut Mondor de Recherche Biomédicale; Université Paris 12, Faculté de médecine, Créteil; Université Paris Diderot and Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Necker; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu,
| | - Jean-François Emile
- From the Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier; L'Institut National de la Santé et de la Recherche Médicale, Unité 955, Institut Mondor de Recherche Biomédicale; Université Paris 12, Faculté de médecine, Créteil; Université Paris Diderot and Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Necker; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu,
| | - Alison H. Banham
- From the Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier; L'Institut National de la Santé et de la Recherche Médicale, Unité 955, Institut Mondor de Recherche Biomédicale; Université Paris 12, Faculté de médecine, Créteil; Université Paris Diderot and Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Necker; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu,
| | - Nicolas Mounier
- From the Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier; L'Institut National de la Santé et de la Recherche Médicale, Unité 955, Institut Mondor de Recherche Biomédicale; Université Paris 12, Faculté de médecine, Créteil; Université Paris Diderot and Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Necker; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu,
| | - Christian Gisselbrecht
- From the Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier; L'Institut National de la Santé et de la Recherche Médicale, Unité 955, Institut Mondor de Recherche Biomédicale; Université Paris 12, Faculté de médecine, Créteil; Université Paris Diderot and Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Necker; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu,
| | - Pierre Feugier
- From the Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier; L'Institut National de la Santé et de la Recherche Médicale, Unité 955, Institut Mondor de Recherche Biomédicale; Université Paris 12, Faculté de médecine, Créteil; Université Paris Diderot and Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Necker; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu,
| | - Bertrand Coiffier
- From the Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier; L'Institut National de la Santé et de la Recherche Médicale, Unité 955, Institut Mondor de Recherche Biomédicale; Université Paris 12, Faculté de médecine, Créteil; Université Paris Diderot and Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Necker; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu,
| | - Thierry J. Molina
- From the Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier; L'Institut National de la Santé et de la Recherche Médicale, Unité 955, Institut Mondor de Recherche Biomédicale; Université Paris 12, Faculté de médecine, Créteil; Université Paris Diderot and Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Necker; Université Paris Descartes; Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu,
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Song MK, Chung JS, Seol YM, Kim SG, Shin HJ, Choi YJ, Cho GJ, Shin DH. Influence of low absolute lymphocyte count of patients with nongerminal center type diffuse large B-cell lymphoma with R-CHOP therapy. Ann Oncol 2009; 21:140-4. [PMID: 19887468 DOI: 10.1093/annonc/mdp505] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Rituximab has dramatic impact on outcome of patients with diffuse large B-cell lymphoma (DLBCL), especially nongerminal center (non-GC) type. A low absolute lymphocyte count (ALC) before rituximab, cyclophosphamide, vincristine, adriamycin, and prednisone (R-CHOP) therapy as a surrogate marker of immune status is associated with poor clinical outcome in DLBCL. Therefore, we hypothesized that low ALC before R-CHOP would have effect on the survival in non-GC type. PATIENTS AND METHODS One hundred and thirty-six DLBCL patients who were treated with R-CHOP from 2003 to 2007 were analyzed in the present study. RESULTS ALC > or = 1.0 x 10(9)/l predicted a longer 3-year progression-free survival (PFS) and 3-year overall survival (OS) versus ALC <1.0 x 10(9)/l (82.6% versus 60.0%, P = 0.005 and 87.2% versus 62.0%, P < 0.001, respectively). Non-GC type had similar PFS and OS to germinal center type (68.2% versus 80.0%, P = 0.074 and 72.7% versus 82.9%, P = 0.111, respectively). However, considering clinical influence of the ALC according to immunophenotype, low ALC in non-GC type DLBCL was associated with lower PFS and OS compared with others (PFS, P = 0.002; OS, P < 0.001). Multivariate analysis revealed that low ALC in non-GC type had lower PFS [hazard ratio (HR) = 3.324, P = 0.001] and OS (HR = 4.318, P < 0.001), independent of international prognostic index. CONCLUSION A low ALC in non-GC type DLBCL counteracted the beneficial effect of rituximab on survival.
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Affiliation(s)
- M-K Song
- Department of Hematology-Oncology, Pusan National University Hospital, Medical Research Institute, Busan, Republic of Korea
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28
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Laszlo D, Pruneri G, Andreola G, Radice D, Calabrese L, Rafaniello PR, Nassi L, Sammassimo S, Alietti A, Agazzi A, Vanazzi A, Martinelli G. Tissue microarrays in diffuse large B-cell lymphomas: are they really able to identify distinct prognostic groups in lymphomas of both nodal and extranodal origin? Int J Surg Pathol 2009; 19:417-24. [PMID: 19793830 DOI: 10.1177/1066896909345596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS Diffuse large B-cell lymphomas (DLBCL) can be divided into different subgroups (germinal center B-cell-like [GCB] and non-GCB) according to their gene expression profiles. Immunohistochemistry has been proposed as a surrogate for identifying these subgroups, but data about its efficacy in providing prognostic information are conflicting. METHODS AND RESULTS This study retrospectively analyzed a series of 105 DLBCL, defined as GCB and non-GCB according to CD10, bcl-6, and MUM1 expression. All patients received a first-line anthracycline-based (CHOP-like) chemotherapy. A total of 50 patients (48%) were identified as GCB and 55 (52%) as non-GCB. The overall response rate was 89% (94/105), with 62 (59%) complete response. Disease progressions were equally distributed between the 2 subgroups and were not significantly different (P = .756) considering the primary site of involvement (nodal or extranodal). The median follow-up was 62 months (range 5-126 months). Overall survival at 5 years was not significantly different between the groups (P = .3468) and was 72.3% and 66.6% for GCB and non-GCB, respectively. CONCLUSION The results do not support the prognostic value of GCB and non-GCB immunohistochemical categories in DLBCL of both nodal and extranodal origin. Furthermore, a limited number of antigens may be not sufficient to identify the same patterns defined by cDNA microarray. Prospective studies are warranted to address this issue.
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Affiliation(s)
- D Laszlo
- European Institute of Oncology, Milan, Italy.
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29
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Xia ZG, Xu ZZ, Zhao WL, Zhao SQ, Ding F, Chen Y, Chen QS, Zheng Y, Zhu Q, Hu JP, Shen ZX, Li JM. The prognostic value of immunohistochemical subtyping in Chinese patients with de novo diffuse large B-cell lymphoma undergoing CHOP or R-CHOP treatment. Ann Hematol 2009; 89:171-7. [PMID: 19669764 DOI: 10.1007/s00277-009-0799-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Accepted: 07/20/2009] [Indexed: 11/29/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease with recognised variability in molecular aetiology and clinical outcome. Though the use of agents such as rituximab significantly improves outcome, intrinsic genetic and morphological factors greatly affect the response to treatment. The objective of this study was to evaluate the prognostic value of immunohistochemical subtyping and the International Prognostic Index (IPI) for predicting treatment outcome in Chinese DLBCL patients. We followed 108 cases of DLBCL and performed prognostic analyses based on molecular subtyping of the disease through immunostaining of tissue samples. The use of rituximab conferred a clinical benefit to DLBCL patients regardless of disease subtype. Importantly, this treatment regimen also improved outcomes in patients with the non-germinal centre B-cell-like (GCB) DLBCL subtype, frequently associated with poorer prognosis. Our results suggest that IPI was the best tool for the prediction of treatment outcome in our patient cohort, regardless of treatment regimen. Furthermore, the use of rituximab alongside classical chemotherapy regimens can improve the outcomes for DLBCL patients who exhibit both GCB and non-GCB subtypes of the disease.
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Affiliation(s)
- Zu-Guang Xia
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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30
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Prognostic impact of activated B-cell focused classification in diffuse large B-cell lymphoma patients treated with R-CHOP. Mod Pathol 2009; 22:1094-101. [PMID: 19448593 DOI: 10.1038/modpathol.2009.73] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Gene expression profiling studies initially enabled diffuse large B-cell lymphoma to be divided into germinal center and activated B-cell-like subtypes, which define high- and low-risk patient groups when treated with chemotherapy. Attempts to reproduce the prognostic classification immunohistochemically have, however, provided inconsistent results. The aim of this study was to determine whether modified immunohistochemical classification of cell of origin focusing on activated B-cell-like markers could be used to predict the outcome of immunochemotherapy-treated diffuse large B-cell lymphoma patients. The expression of CD10, Bcl-6, MUM1/IRF4, Bcl-2, and FOXP1 was determined immunohistochemically from 88 samples of diffuse large B-cell lymphoma patients treated uniformly with R-CHOP. When the modified classification using MUM1/IRF4 and FOXP1 positivities as activated B-cell-like markers was applied to distinguish the patients between the activated B-cell-like and other diffuse large B-cell lymphoma subtypes, a significantly worse outcome was seen for the patients with the activated B-cell-like phenotype (3-year failure-free survival 63 vs 82%, P=0.048, overall survival 69 vs 85%, P=0.110). Similarly, according to the Muris algorithm, the group 2 patients representing Bcl-2-positive post-germinal center patients showed an inferior outcome in comparison to the group 1 patients (failure-free survival 59 vs 81%, P=0.041, overall survival 67 vs 82%, P=0.159). In contrast, when the classification of the same cohort was performed according to the Hans algorithm, no significant difference in survival was observed between the germinal center and non-germinal center patients. In conclusion, the data suggest that both the modified activated B-cell-like and Muris classifications define the non-germinal center phenotype as an adverse risk factor in R-CHOP-treated diffuse large B-cell lymphoma patients.
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Morito T, Fujihara M, Asaoku H, Tari A, Sato Y, Ichimura K, Tanaka T, Takata K, Tamura M, Yoshino T. Serum soluble interleukin-2 receptor level and immunophenotype are prognostic factors for patients with diffuse large B-cell lymphoma. Cancer Sci 2009; 100:1255-60. [PMID: 19432905 DOI: 10.1111/j.1349-7006.2009.01167.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Diffuse large B-cell lymphoma is the most common form of non-Hodgkin lymphoma. Although many studies have attempted to identify prognostic factors, most have focused on conventionally treated patients. The influence of anti-CD20 antibody (rituximab) should be considered now. We evaluated the prognostic significance of serum soluble interleukin-2 receptor levels and germinal center B-cell-like or non-germinal center B-cell like subgroups in 80 patients with diffuse large B-cell lymphoma, who had been treated with rituximab. Serum soluble interleukin-2 receptor levels ranged from 322 to 39900 U/mL (median 1365 U/mL). Sixteen (20%) were germinal center B-cell-like subgroups, and the remainder (80%) non-germinal center B-cell-like. Survival analysis associated lower serum soluble interleukin-2 receptor level and germinal center B-cell-like phenotype with better overall survival (P = 0.015), whereas multivariate analysis, including International Prognostic Index factors, revealed that only higher performance status score and higher serum lactate dehydrogenase levels significantly affected survival. However, serum soluble interleukin-2 receptor levels were elevated in patients with higher International Prognostic Index scores as well as in the non-germinal center B-cell-like subgroup. Serum soluble interleukin-2 receptor levels, International Prognostic Index, and subphenotypes were strongly correlated with each other. Our study showed that soluble interleukin-2 receptor is quite useful and may serve as a substitute for the International Prognostic Index, especially for patients undergoing treatment. Moreover, the differentiation between the germinal center B-cell-like and non-germinal center B-cell-like phenotypes is also useful for predicting patients with diffuse large B-cell lymphoma, even among those treated with rituximab.
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Affiliation(s)
- Toshiaki Morito
- Department of Pathology, Okayama University Graduate School of Medical, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, USA
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32
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Miles RR, Raphael M, McCarthy K, Wotherspoon A, Lones MA, Terrier-Lacombe MJ, Patte C, Gerrard M, Auperin A, Sposto R, Davenport V, Cairo MS, Perkins SL. Pediatric diffuse large B-cell lymphoma demonstrates a high proliferation index, frequent c-Myc protein expression, and a high incidence of germinal center subtype: Report of the French-American-British (FAB) international study group. Pediatr Blood Cancer 2008; 51:369-74. [PMID: 18493992 PMCID: PMC2712231 DOI: 10.1002/pbc.21619] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Diffuse large B-cell lymphoma (DLBCL) makes up 10-20% of pediatric non-Hodgkin lymphoma, and these patients have a significantly better prognosis than adults with DLBCL. The difference in prognosis may be related to clinical, phenotypic, and/or biological differences between adult and pediatric DLBCL. In adult DLBCL, the germinal center (GC) phenotype is associated with a better prognosis than the activated B-cell (ABC) phenotype. However, a high proliferative index and expression of Bcl2 and c-Myc protein have all been associated with worse outcomes. While multiple studies have addressed the phenotype and expression patterns of adult DLBCL, relatively little is known about these biological variables in pediatric DLBCL. The goal of this study was to investigate the proliferative index, the relative frequencies of the GC and non-GC subtypes, and the expression of Bcl2 and c-Myc protein in a cohort of children with DLBCL treated in a uniform manner. PROCEDURE We performed immunohistochemistry (IHC) for MIB1, CD10, Bcl6, MUM1, Bcl2, and c-Myc on DLBCL tissue from children treated uniformly in the FAB LMB96 trial (SFOP LMB96/CCG5961/UKCCSG/NHL 9600). RESULTS Compared to published adult DLBCL studies, pediatric DLBCL demonstrated moderate to high proliferation rates (83%), increased c-Myc protein expression (84%), decreased Bcl2 protein expression (28%), and an increased frequency of the GC phenotype (75%). CONCLUSIONS These findings suggest that there are significant biologic differences between pediatric and adult forms of DLBCL, which may contribute to the superior prognosis seen in the pediatric population relative to adult disease.
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Affiliation(s)
| | - Martine Raphael
- Univ Paris- Sud, INSERM U 802, -CHU Bicêtre AP-HP, Le Kremlin-Bicêtre F 94270, France
| | - Keith McCarthy
- Gloucestershire Hospitals, NHS Foundation Trust, Gloucestershire, UK
| | | | - Mark A. Lones
- Children's Hospital of Orange County/St. Joseph Hospital, Orange, CA, USA
| | | | | | | | - Anne Auperin
- Institut de Cancérologie Gustave Roussy, Villejuif, France
| | - Richard Sposto
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Mitchell S. Cairo
- Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University, New York, NY, USA
| | - Sherrie L. Perkins
- University of Utah Health Sciences Center, Salt Lake City, UT, USA,Address for Correspondence: Sherrie L. Perkins, M.D., Ph.D., Department of Pathology, University of Utah Health Sciences Center, 50 N Medical Drive Room A513, Salt Lake City, UT 84132, (801) 581-5854, Fax: (801) 585-3831,
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33
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Vujasinovic-Stupar N, Pejnovic N, Markovic O, Babic G. Influence of rituximab–CHOP therapy on clinical course and autoimmune parameters in rheumatoid arthritis associated with diffuse large B cell non-Hodgkin lymphoma. Ann Hematol 2008; 87:767-9. [DOI: 10.1007/s00277-008-0475-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2007] [Accepted: 02/25/2008] [Indexed: 11/24/2022]
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