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Blood, 1 June 2006, Vol. 107, No. 11, pp. 4207-4213. Prepublished online as a Blood First Edition Paper on January 31, 2006; DOI 10.1182/blood-2005-10-4222. This Article Full Text (PDF) Erratum (v109,p2292) All Versions of this Article: 2005-10-4222v1 107/11/4207    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 CrossRef Citing Articles via Google Scholar Google Scholar Articles by Winter, J. N Articles by Gascoyne, R. D Search for Related Content PubMed PubMed Citation Articles by Winter, J. N Articles by Gascoyne, R. D Related Collections Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted October 24, 2005 Accepted January 18, 2006 Prognostic significance of Bcl-6 protein expression in DLBCL treated with CHOP or R-CHOP: a prospective correlative study Jane N Winter*, Edie A Weller, Sandra J Horning, Maryla Krajewska, Daina Variakojis, Thomas M Habermann, Richard I Fisher, Paul J Kurtin, William R Macon, Mukesh Chhanabhai, Raymond E Felgar, Eric D Hsi, L J Medeiros, James K Weick, John C Reed, and Randy D Gascoyne Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA Dana Farber Cancer Institute, Boston, MA, USA Stanford University, Stanford, CA, USA Burnham Institute for Medical Research, La Jolla, CA, USA Mayo Clinic College of Medicine, Rochester, MN, USA James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA British Columbia Cancer Agency, Vancouver, British Columbia, Canada Cleveland Clinic, Cleveland, OH, USA MD Anderson Cancer Center, Houston, TX, USA Hematology Oncology Associates of the Palm Beaches, Lake Worth, FL, USA * Corresponding author; email: j-winter{at}northwestern.edu. Bcl-6 protein expression, a marker of germinal center origin, has been associated with a favorable prognosis in diffuse large B-cell lymphoma (DLBCL). To determine the prognostic significance of this marker when rituximab (R) was added to CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy, we prospectively studied bcl-6 protein expression by immunohistochemical staining of 199 paraffin-embedded specimens from patients enrolled on the US Intergroup phase III trial comparing R-CHOP to CHOP with or without maintenance R. In bcl-6 negative patients, failure-free and overall survival (FFS, OS) was prolonged for those treated with R-CHOP alone compared to CHOP alone (2-year FFS 76% vs. 9%, p=0.00007; 2-year OS 79% vs. 17%, p=0.0003). In contrast, no differences in FFS and OS were detected between treatment arms for bcl-6-positive cases. In the multivariate analysis, treatment arm (CHOP vs. R-CHOP) was the major determinant of both FFS (p=0.0004) and OS (p=0.00004) for the bcl-6-negative subset, whereas International Prognostic Index risk group was the only significant predictor of outcome among bcl-6-positive cases. Bcl-2 protein expression was not predictive of outcome in either group. In this study, we observed a reduction in treatment failures and death with the addition of R to CHOP in bcl-6 negative DLBCL cases only. Our finding that bcl-6-positive cases did not benefit from the addition of R to CHOP, requires independent confirmation. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Is it time to stop treating subsets of DLBCL with R-CHOP? Craig Moskowitz Blood 2006 107: 4197-4198. [Full Text] [PDF]

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