Prognostic impact of immunohistochemical and molecular genetic markers in Diffuse Large B-cell lymphoma
Medical Council(2019)
Abstract
Aim: To identify incidence and prognostic impact of different IHC and molecular genetic markers in Diffuse Large B-cell lymphoma. Methods: We analyzed 215 patients with DLBCL who received treatment from 2008 to 2016. We assess expression of different IHC markers, defined DLBCL to GCB and non-GCB subtypes by Hans-algorithm and performed FISH to evaluate MyC, BcL2 and BCL6 translocations. Results: Median follow-up was 29 months. Non-GCB DLBCL were identified in 44 pts (62,9%), GCB-subtype in 26 pts (37,1%). Median PFS in non-GCB DlBCL was 46,0 months, in GCB DLBCL median PFS and 75% quartile was not reached (p=0,171). Traslocations of MYC, BCL2 and BCL6 were found in 10/48 pts (20,8%). Double expression of c-myc and bcl-2 was identified in 21 of 71 пациентов (29,6%). СD5-expression were determined in 19/55 (34,5%), CD30+ DLBCL - in 24/66 pts (36,4%). In pts with DLBCL without CD-10 expression PFS was 6,0 months, in group with CD 10 expression median of PFS was not reached (р=0,122). Pts with CD 10 expression had lower risk of relapse compared to those without expression (р=0,049). Absence of CD 10 expression was negative prognostic factor for PFS in multivariate analysis (р=0,015). Conclusion: Patients with DLBCL and GCB subtype have tendency to better prognosis in PFS rates and lower risk of relapse compared to non-GCB subtype. Dividing to GCB or non-GCB subtypes in DLBCL and assessment of different IHC markers can potentially determine DLBCL with worse prognosis.
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Key words
diffuse large b-cell lymphoma (dlbcl),high-grade lymphoma,primary-refractory disease,с-myc,bcl-2,p53
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