BCL6公司
医学
弥漫性大B细胞淋巴瘤
淋巴瘤
内科学
免疫组织化学
荧光原位杂交
人口
IRF4公司
CD5型
肿瘤科
病理
生物
免疫学
B细胞
抗体
转录因子
基因
环境卫生
生发中心
生物化学
染色体
作者
Heike Horn,Marita Ziepert,Martin Wartenberg,Annette M. Staiger,Thomas Barth,Bernd Hw,Alfred C. Feller,Wolfram Klapper,Christiane Stuhlmann-Laeisz,Michael Hummel,Harald Stein,Dido Lenze,Sven Hartmann,Hansmann Ml,Peter Möller,Sergio Cogliatti,Michael Pfreundschuh,Lorenz Trümper,Markus Loeffler,Bertram Glass,Norbert Schmitz,German Ott,Andreas Rosenwald
出处
期刊:Leukemia
[Springer Nature]
日期:2015-02-17
卷期号:29 (7): 1564-1570
被引量:57
摘要
Prognostically relevant risk factors in patients with diffuse large B-cell lymphoma (DLBCL) have predominantly been evaluated in elderly populations. We tested whether previously described risk factors are also valid in younger, poor-prognosis DLBCL patients. Paraffin-embedded samples from 112 patients with de novo DLBCL, enrolled in the R-MegaCHOEP trial of the German High Grade Non-Hodgkin Lymphoma Study Group (DSHNHL) were investigated using immunohistochemistry (MYC, FOXP1, LMO2, GCET1, CD5, CD10, BCL2, BCL6, IRF4/MUM1) and fluorescence in situ hybridization (MYC, BCL2, BCL6). MYC, BCL2 and BCL6 breaks occurred in 14, 21 and 31%, respectively. In the majority of cases, MYC was simultaneously rearranged with BCL2 and/or BCL6. The adverse impact of MYC rearrangements was confirmed, but the sole presence of BCL2 breaks emerged as a novel prognostic marker associated with inferior overall survival (OS) (P=0.002). Combined overexpression of MYC and BCL2 showed only limited association with inferior OS. All immunohistochemical cell of origin classifiers applied failed to predict survival time. DLBCL tumors with significant proportion of immunoblastic and/or immunoblastic-plasmacytoid cells had inferior OS, independently from from BCL2 break. Younger, poor-prognosis DLBCL patients, therefore, display different biological risk factors compared with an elderly population, with BCL2 translocations emerging as a powerful negative prognostic marker.