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Blood, 1 February 2002, Vol. 99, No. 3, pp. 815-821
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
De novo CD5+ diffuse large B-cell lymphoma: a
clinicopathologic study of 109 patients
Motoko Yamaguchi,
Masao Seto,
Masataka Okamoto,
Ryo Ichinohasama,
Naoya Nakamura,
Tadashi Yoshino,
Junji Suzumiya,
Takuhei Murase,
Ikuo Miura,
Takashi Akasaka,
Jun-ichi Tamaru,
Ritsuro Suzuki,
Yoshitoyo Kagami,
Masami Hirano,
Yasuo Morishima,
Ryuzo Ueda,
Hiroshi Shiku, and
Shigeo Nakamura
From the Second Department of Internal Medicine,
Mie University School of Medicine, Tsu, Japan; Division of Molecular
Medicine, Department of Hematology and Chemotherapy, and Department of
Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya,
Japan; Department of Internal Medicine, Fujita Health University School
of Medicine, Toyoake, Japan; Department of Oral Pathology, Tohoku
University School of Medicine, Sendai, Japan; First Department of
Pathology, Fukushima Medical College, Japan; Department of Pathology,
Okayama University Graduate School of Medicine and Dentistry, Japan;
First Department of Internal Medicine, Fukuoka University School of
Medicine, Japan; Department of Hematology, Nishio Municipal Hospital,
Japan; Third Department of Internal Medicine, Akita University School
of Medicine, Japan; First Division, Department of Internal Medicine,
Faculty of Medicine, Kyoto University, Japan; Department of Pathology,
Saitama Medical Center, Saitama Medical School, Kawagoe, Japan; Second
Department of Internal Medicine, Nagoya City University Medical School,
Japan.
De novo CD5+ diffuse large B-cell lymphoma
(CD5+ DLBCL) is known to have phenotypically and
genotypically different characteristics than CD5 DLBCL
and mantle cell lymphoma (MCL). To further characterize CD5+ DLBCL, 109 patients with CD5+ DLBCL were
reviewed, and the results were compared with those of 384 CD5 DLBCL and 128 cyclin D1+ MCL patients.
Patients with CD5+ DLBCL showed a higher age
distribution (median, 66 years; P = .0083) and a
female predominance (male-female ratio, 49:60, P = .011)
compared with those with CD5 DLBCL. CD5+
DLBCL was more closely associated with many aggressive clinical features or parameters than CD5 DLBCL: 69% older than 60 years (P = .039), 34% with performance status greater
than 1 (P = .0016), 69% with serum lactate dehydrogenase level higher than normal (P < .0001), 62% with stage
III/IV disease at diagnosis (P = .0023), 35% with more
than one extranodal site (P = .023), and 40% with B
symptoms (P = .0031). The overall International Prognostic Index score was thus significantly higher for the
patients with CD5+ DLBCL than for those with
CD5 DLBCL (P = .00005). The most
frequent site of extranodal involvement was bone marrow (28%), a
higher frequency than that for CD5 DLBCL
(P < .0001) but lower than that for cyclin
D1+ MCL (P = .0015). Histopathologically,
CD5+ DLBCL showed centroblastic morphology except for 3 patients with immunoblastic disease, and interfollicular growth
pattern (7%) and intravascular or intrasinusoidal
infiltration (19%) were observed. Immunophenotypically,
CD5+ DLBCL was characterized by a
CD5+CD10CD19+ CD20+CD21CD23
cyclin D1 phenotype and a predominance of surface
IgM . Of particular interest is that CD5+ DLBCL was
characterized by a survival curve significantly inferior to that for
patients with CD5 DLBCL (P = .0026). These
findings suggest that CD5+ DLBCL may constitute a unique
subgroup of DLBCL.
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