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 Blood, 1 September 2005, Vol. 106, No. 5, pp. 1762-1769.
Prepublished online as a Blood First Edition Paper on May 19, 2005; DOI 10.1182/blood-2004-12-4631.

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NEOPLASIA

AIDS-related B-cell lymphoma (ARL): correlation of prognosis with differentiation profiles assessed by immunophenotyping

Christian Hoffmann, Markus Tiemann, Carsten Schrader, Dirk Janssen, Eva Wolf, Mathias Vierbuchen, Reza Parwaresch, Karen Ernestus, Andreas Plettenberg, Albrecht Stoehr, Gerd Fatkenheuer, Christoph Wyen, Mark Oette, and Heinz-August Horst

From the II Department of Medicine, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany; the Institute of Hematopathology and Lymphnode Registry of the University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany; the Kuratorium für Immunschwäche (KIS), Munich, Germany; the Hospital of St Georg, Hamburg, Germany; the Institute of Pathology, University Clinic of Cologne, Cologne, Germany; the Department of Internal Medicine, University Clinic of Cologne, Cologne, Germany; the Institute for Interdisciplinary Infectiology (IFI), Hamburg, Germany; and the University Clinic of Düsseldorf, Düsseldorf, Germany.

This study was undertaken to analyze the differentiation profiles assessed by immunophenotyping in AIDS-related B-cell lymphoma (ARL) and their relation to the clinical course. Paraffin-embedded sections of 89 ARL cases during 1989 to 2004 were stained immunohistochemically with antibodies to CD3, CD10, CD20, CD38, CD138/Syndecan-1 (Syn-1), multiple myeloma-1/interferon regulatory factor-4 (MUM1/IRF4), B-cell lymphoma protein-2 (BCL-2), BCL-6, latent membrane protein-1 (LMP-1), and Ki-67. Expression of CD10 and CD20 were associated with better overall survival (OS; P = .009 and P = .04, respectively). Expression of CD20 was associated with longer disease-free survival (DFS; P = .03), whereas expression of CD138/Syn-1 was associated with shorter DFS (P = .03). OS and DFS were worse in patients with immunophenotypic profiles related to post-germinal center (GC) differentiation (BCL-6 and CD10 negative, MUM1/IRF4 and/or CD138/Syn-1 positive) when compared with GC differentiation (P = .01). When controlled for age-adjusted International Prognostic Index (IPI), prior AIDS-defining illness (ADI), and year of ARL diagnosis, a post-GC differentiation remained significantly associated with poor OS and DFS. Expression of CD10 was associated with a preserved immunocompetence, whereas CD20 was less frequent in patients developing ARL while on highly active antiretroviral therapy (P = .04). In summary, lack of CD20 or CD10 expression and a post-germinal center signature are associated with a worse prognosis in ARL. (Blood. 2005;106:1762-1769)


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