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Prepublished online as a Blood First Edition Paper on June 7, 2002; DOI 10.1182/blood-2002-02-0654.

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Submitted February 28, 2002
Accepted May 27, 2002

Human leukocyte antigens class II (HLA DRB1) and tumor necrosis factor genetic polymorphisms are independent predictors of non-Hodgkin's lymphoma outcome

Przemyslaw Juszczynski, Ewa Kalinka, Jacques Bienvenu, Grzegorz Woszczek, Maciej Borowiec, Tadeusz Robak, Marek Kowalski, Ewa Lech-Maranda, Lucile Baseggio, Bertrand Coiffier, Gilles Salles, and Krzysztof Warzocha*

Hematology, Medical University of Lodz, Lodz, Poland
Jeune Equipe, Universite Claude Bernard, Lyon, France
Clinical Immunology, Medical University of Lodz, Lodz, Poland
Hematology, Medical University of Lodz, Lodz, Poland; Jeune Equipe, Universite Claude Bernard, Lyon, France
Service d'Hematologie, Centre Hospitalier Lyon-Sud, Lyon, France; Jeune Equipe, Universite Claude Bernard, Lyon, France

* Corresponding author; email: warzocha{at}psk2.am.lodz.pl.

Tumor necrosis factor (TNF) production and non-Hodgkin's lymphoma (NHL) outcome was found to be related to the TNF-308 polymorphism. To explore whether this could be linked to neighboring polymorphisms, we genotyped the TNF-376,-308,-238,-163, lymphotoxin alpha (LT{alpha})+252, and HLA DRB1 alleles in 204 NHL patients and 120 controls. TNF-308A was the only allele associated with higher TNF and its p55 and p75 receptors' levels (p=.009, p=.03, and p=.007) and lower complete remission rates (p=.006). Freedom from progression (FFP) and overall survival (OS) were shorter in patients with TNF-308A (p=.009 and p=.02), null HLA DRB1*02 allele (p=.007 and p=.14), or both genetic markers (p=.004 and p=.005). Multivariate analysis incorporating International Prognostic Index (IPI) identified TNF-308A (p<.0001, relative risk [RR]=1.63; p<.0001, RR=1.51) and null HLA DRB1*02 alleles (p=.015, RR=1.18; p<.0001, RR=1.25) as independent factors for FFP and OS. These results indicate the existence of at least two inherited factors involved in NHL outcome.


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