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Blood, 15 May 2004, Vol. 103, No. 10, pp. 3662-3668. Prepublished online as a Blood First Edition Paper on January 15, 2004; DOI 10.1182/blood-2003-08-2726. This Article Full Text (PDF) All Versions of this Article: 2003-08-2726v1 103/10/3662    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Grange, F. Articles by Wechsler, J. Search for Related Content PubMed PubMed Citation Articles by Grange, F. Articles by Wechsler, J. Social Bookmarking                   What's this? Submitted August 11, 2003 Accepted December 26, 2003 Bcl-2 protein expression is the strongest independent prognostic factor of survival in Primary Cutaneous Large B-Cell Lymphomas Florent Grange*, Tony Petrella, Marie Beylot-Barry, Pascal Joly, Michel D'Incan, Michele Delaunay, Laurent Machet, Marie-Francoise Avril, Sophie Dalac, Philippe Bernard, Agnes Carlotti, Eric Esteve, Beatrice Vergier, Pierre Dechelotte, Elisabeth Cassagnau, Philippe Courville, Philippe Saiag, Liliane Laroche, Martine Bagot, and Janine Wechsler Dermatology, Hopital Pasteur, Colmar, France Pathology and Centre de Pathologie, Hopital du Bocage, Dijon, France Dermatology, Hopital du Haut-Leveque, Pessac, France Dermatology, Hopital Charles Nicolle, Rouen, France Dermatology, Hotel-Dieu, Clermont-Ferrand, France Dermatology and Cancerology, Hopital Pellegrin, Bordeaux, France Dermatology, Hopital Trousseau, Tours, France Dermatology, Institut Gustave Roussy, Villejuif, France Dermatology, Hopital du Bocage, Dijon, France Dermatology, Hopital Robert Debre, Reims, France Pathology, Hopital Tarnier, Paris, France Dermatology, Hopital Porte Madeleine, Orleans, France Pathology, Hopital du Haut-Leveque, Pessac, France Pathology, Hotel-Dieu, Clermont-Ferrand, France Pathology, Hotel-Dieu, Nantes, France Pathology, Hopital Charles Nicolle, Rouen, France Dermatology, Hopital Ambroise Pare, Boulogne, France Dermatology, Hopital Avicenne, Bobigny, France Dermatology, Hopital Henri-Mondor, Creteil, France Pathology, Hopital Henri-Mondor, Creteil, France * Corresponding author; email: florent.rgange{at}ch-colmar.rss.fr. Bcl-2 protein expression has been associated with poor prognosis in patients with non-cutaneous diffuse large B-cell lymphomas. In primary cutaneous large B-cell lymphomas, the location on the leg, the round-cell morphology defined as the predominance of centroblasts and immunoblasts over large centrocytes, and multiple skin lesions were identified as adverse prognostic factors. The prognostic value of bcl-2 protein expression has not been studied in large series of patients. We evaluated 80 primary cutaneous large B-cell lymphomas collected by the French Study Group on Cutaneous Lymphoma. The prognostic value of age, sex, number of lesions, cutaneous extent, location, LDH level, B symptoms, morphology and bcl-2 protein expression was studied. The overall 5-year specific survival rate was 65%. In univariate analysis, advanced age, multiple skin lesions (n=48), location on the leg (n=25), round-cell morphology (n=32) and bcl-2 expression (n=39) were significantly related to death from lymphoma. In multivariate analysis, bcl-2 expression (p=.0003), multiple skin lesions (p=.001) and age remained independent prognostic factors. Five-year specific survival rates in bcl-2+ and bcl-2- patients were 41% and 89% respectively (p<.0001). A new prognostic classification of primary cutaneous B-cell lymphoma should be based primarily on bcl-2 protein expression rather than the location of skin lesions. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: F. Grange and F. Antonicelli Cutaneous Lymphomas: What Can We Learn From Location? Arch Dermatol, June 1, 2009; 145(6): 710 - 712. [Full Text] [PDF] P. T. Bradford, S. S. Devesa, W. F. Anderson, and J. R. Toro Cutaneous lymphoma incidence patterns in the United States: a population-based study of 3884 cases Blood, May 21, 2009; 113(21): 5064 - 5073. [Abstract] [Full Text] [PDF] M. A. Habra, E. J. Weaver, and P. V. Prewitt III Primary Cutaneous Large B-Cell Lymphoma of the Leg and Acute Hypercalcemia J. Clin. Oncol., December 20, 2007; 25(36): 5825 - 5826. [Full Text] [PDF] F. Grange, M. Beylot-Barry, P. Courville, E. Maubec, M. Bagot, B. Vergier, P. Souteyrand, L. Machet, S. Dalac, E. Esteve, et al. Primary Cutaneous Diffuse Large B-Cell Lymphoma, Leg Type: Clinicopathologic Features and Prognostic Analysis in 60 Cases Arch Dermatol, September 1, 2007; 143(9): 1144 - 1150. [Abstract] [Full Text] [PDF] N. J. Senff, J. J. Hoefnagel, P. M. Jansen, M. H. Vermeer, J. van Baarlen, W. A. Blokx, M. R. Canninga-van Dijk, M.-L. Geerts, K. M. Hebeda, P. M. Kluin, et al. Reclassification of 300 Primary Cutaneous B-Cell Lymphomas According to the New WHO-EORTC Classification for Cutaneous Lymphomas: Comparison With Previous Classifications and Identification of Prognostic Markers J. Clin. Oncol., April 20, 2007; 25(12): 1581 - 1587. [Abstract] [Full Text] [PDF] L Cerroni Lymphoproliferative lesions of the skin. J. Clin. Pathol., August 1, 2006; 59(8): 813 - 826. [Abstract] [Full Text] [PDF] P. L. Zinzani, P. Quaglino, N. Pimpinelli, E. Berti, G. Baliva, S. Rupoli, M. Martelli, M. Alaibac, G. Borroni, S. Chimenti, et al. Prognostic Factors in Primary Cutaneous B-Cell Lymphoma: The Italian Study Group for Cutaneous Lymphomas J. Clin. Oncol., March 20, 2006; 24(9): 1376 - 1382. [Abstract] [Full Text] [PDF] K. Kodama, C. Massone, A. Chott, D. Metze, H. Kerl, and L. Cerroni Primary cutaneous large B-cell lymphomas: clinicopathologic features, classification, and prognostic factors in a large series of patients Blood, October 1, 2005; 106(7): 2491 - 2497. [Abstract] [Full Text] [PDF] C. Hoffmann, M. Tiemann, C. Schrader, D. Janssen, E. Wolf, M. Vierbuchen, R. Parwaresch, K. Ernestus, A. Plettenberg, A. Stoehr, et al. AIDS-related B-cell lymphoma (ARL): correlation of prognosis with differentiation profiles assessed by immunophenotyping Blood, September 1, 2005; 106(5): 1762 - 1769. [Abstract] [Full Text] [PDF] B. D. Smith, G. L. Smith, D. L. Cooper, and L. D. Wilson The Cutaneous B-Cell Lymphoma Prognostic Index: A Novel Prognostic Index Derived From a Population-Based Registry J. Clin. Oncol., May 20, 2005; 23(15): 3390 - 3395. [Abstract] [Full Text] [PDF] R. Willemze, E. S. Jaffe, G. Burg, L. Cerroni, E. Berti, S. H. Swerdlow, E. Ralfkiaer, S. Chimenti, J. L. Diaz-Perez, L. M. Duncan, et al. WHO-EORTC classification for cutaneous lymphomas Blood, May 15, 2005; 105(10): 3768 - 3785. [Abstract] [Full Text] [PDF] E. S. Jaffe Cutaneous lymphomas: it's location, location, location Blood, May 1, 2005; 105(9): 3394 - 3395. 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