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Blood, 1 June 2007, Vol. 109, No. 11, pp. 4930-4935.
Prepublished online as a Blood First Edition Paper on February 13, 2007; DOI 10.1182/blood-2006-09-047068.
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NEOPLASIA
Prognostic impact of immunohistochemically defined germinal center phenotype in diffuse large B-cell lymphoma patients treated with immunochemotherapy
Heidi Nyman1,2,
Magdalena Adde3,
Marja-Liisa Karjalainen-Lindsberg4,
Minna Taskinen1,2,
Mattias Berglund3,
Rose-Marie Amini5,
Carl Blomqvist1,3,
Gunilla Enblad3, and
Sirpa Leppä1,2
1 Department of Oncology, Helsinki University Central Hospital, Finland;
2 Molecular Cancer Biology Research Program, Biomedicum Helsinki, University of Helsinki, Finland;
3 Department of Oncology, Uppsala University Hospital, Sweden;
4 Department of Pathology, Haartman Institute, University of Helsinki, Finland;
5 Department of Genetics and Pathology, University of Uppsala, Sweden
Germinal center (GC) and non-GC phenotypes are predictors of outcome in diffuse large B-cell lymphoma (DLBCL) and can be used to stratify chemotherapy-treated patients into low- and high-risk groups. To determine how combination of rituximab with chemotherapy influences GC-associated clinical outcome, GC and non-GC phenotypes were identified immunohistochemically from samples of 90 de novo DLBCL patients treated with rituximab in combination with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)–like regimen (immunochemotherapy). One hundred and four patients previously treated with chemotherapy served as a control group. Consistent with previous studies, chemotherapy-treated patients with immunohistochemically defined GC phenotype displayed a significantly better overall (OS) and failure-free survival (FFS) than the non-GC group (OS, 70% vs 47%, P = .012; FFS, 59% vs 30%, P = .001). In contrast, immunohistochemically defined GC phenotype did not predict outcome in immunochemotherapy-treated patients (OS, 77% vs 76%, P = ns; FFS, 68% vs 63%, P = ns). In comparison, International Prognostic Index (IPI) could separate the high-risk patients from low- and intermediate-risk groups (OS, 84% vs 63%, P = .030; FFS, 79% vs 52%, P = .028). We conclude that rituximab in combination with chemotherapy seems to eliminate the prognostic value of immunohistochemically defined GC- and non-GC phenotypes in DLBCL.

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