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Blood, 15 October 2006, Vol. 108, No. 8, pp. 2720-2725.
Prepublished online as a Blood First Edition Paper on April 11, 2006; DOI 10.1182/blood-2006-01-009480.


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NEOPLASIA

FCGR3A gene polymorphisms may correlate with response to frontline R-CHOP therapy for diffuse large B-cell lymphoma

Dong Hwan Kim, Hee Du Jung, Jong Gwang Kim, Je-Jung Lee, Deok-Hwan Yang, Yeon Hee Park, Young Rok Do, Ho Jin Shin, Min Kyoung Kim, Myung Soo Hyun, and Sang Kyun Sohn

From the Departments of Hematology/Oncology and Laboratory Medicine, Kyungpook National University Hospital, Daegu, Korea; Department of Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Hematology/Oncology, Chonnam National University Hwasun Hospital, Jeollanamdo, Korea; Department of Hematology/Oncology, Korean Cancer Center Hospital, Seoul, Korea; Department of Hematology/Oncology, Keimyung University, Dongsan Medical Center, Daegu, Korea; Department of Hematology/Oncology, Pusan National University Hospital, Busan, Korea; and Department of Hematology/Oncology, Yeungnam University, Yeungnam Medical Center, Daegu, Korea.

The precise mechanism of rituximab plus cyclophosphamide/doxorubicin/vincristine/prednisone (R-CHOP) therapy in diffuse large B-cell lymphoma (DLBCL) is not fully elucidated. Besides overcoming bcl-2-mediated chemoresistance, antibody-dependent cellular cytotoxicity (ADCC), which is activated by effector cells via immunoglobulin G (IgG) fragment C receptors (FcRs), was also proposed as a mechanism of rituximab. The current study evaluated the impact of FcR polymorphism on the response to R-CHOP therapy for DLBCL with the basis that FcR polymorphism can affect rituximab's affinity for ADCC effector cells. The FCGR3A and FCGR2A gene polymorphisms were determined in DLBCL patients receiving R-CHOP (n = 113) compared with CHOP therapy (n = 85). The FCGR3A valine (V) allele was significantly correlated with a higher complete response rate to R-CHOP compared with the phenylalanine (F) allele (88% in V/V vs 79% in V/F vs 50% in F/F; P = .002), while no difference was found between FCGR2A polymorphisms. In addition, V/V allele was associated with faster achievement of response than other alleles. The impact of the FCGR3A gene polymorphism on response rate was not noted in the CHOP group. In terms of overall or event-free survival, no difference was found according to FCGR3A or FCGR2A alleles. The FCGR3A single nucleotide polymorphism (SNP) is predictive of response to R-CHOP, but does not correlate with survival in patients with DLBCL.


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