Cell‐of‐origin determined by both gene expression profiling and immunohistochemistry is the strongest predictor of survival in patients with diffuse large B‐cell lymphoma

Abdulla, Maysaa; Hollander, Peter; Pandzic, Tatjana; Mansouri, Larry; Ednersson, Susanne Bram; Andersson, Per‐Ola; Hultdin, Magnus; Fors, Maja; Erlanson, Martin; Degerman, Sofie; Petersen, Helga Munch; Asmar, Fazila; Grønbæk, Kirsten; Enblad, Gunilla; Cavelier, Lucia; Rosenquist, Richard; Amini, Rose‐Marie

doi:10.1002/ajh.25666

Cited by 28 publications

(23 citation statements)

References 40 publications

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“…In one hand, GC and ABC subtypes were defined by gene expression analysis (GEP), even in formalin fixed paraffin embedded samples, using different technologies such as Lymph2X, which identified patient groups with significantly different outcomes after R-CHOP [ 61 ], particularly in the presence of BCL2 alterations [ 62 ]. When GEP analysis is not available in clinical practice, the immunohistochemistry (IHC) based Hans algorithm [ 63 ] can be used as a surrogate marker, since it displays an overall concordance of 72% with GEP [ 64 ]. In EBV + DLBCL characterized with Hans immunohistochemical markers, ABC-associated proteins IRF4, MUM1, are typically positive, whereas GC markers CD10 and BCL6 are usually negative.…”

Section: Cellular Gene Expressionmentioning

confidence: 99%

Advances in the Pathogenesis of EBV-Associated Diffuse Large B Cell Lymphoma

Chabay

2021

Cancers

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Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin’s lymphoma (NHL) in adults. Epstein–Barr virus (EBV) positive DLBCL of the elderly was defined by the World Health Organization (WHO) in 2008, it was restricted only to patients older than 50 years old, and it was attributed to immunesenescence associated with physiological aging. After the description of EBV-associated DLBCL in children and young adults, the WHO redefined the definition, leading to the substitution of the modifier “elderly” with “not otherwise specified” (EBV + DLBCL, NOS) in the updated classification, and it is no more considered provisional. The incidence of EBV + DLBCL, NOS varies around the world, in particular influenced by the percentage of EBV+ cells used as cut-off to define a case as EBV-associated. EBV has effect on the genetic composition of tumor cells, on survival, and at the recruitment of immune cells at the microenvironment. In this review, the role of EBV in the pathogenesis of DLBCL is discussed.

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Section: Cellular Gene Expressionmentioning

confidence: 99%

Advances in the Pathogenesis of EBV-Associated Diffuse Large B Cell Lymphoma

Chabay

2021

Cancers

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“…Along with this, the prognostic significance of international prognostic index (IPI) was impaired and could only distinguish the low-risk with the high-risk group instead of the four risk groups as previously described (3)(4)(5). Alternatively, more and more clinical and biological markers were explored to predict the prognosis of DLBCL, including age, extranodal lesions, cell of origin, c-MYC and Bcl-2 co-expression or translocation, and different biochemical indicators (6)(7)(8)(9)(10)(11)(12)(13)(14). As the treatment developed, the prognostic values of these biochemical indicators may also change.…”

Section: Introductionmentioning

confidence: 99%

Consecutive Hypoalbuminemia Predicts Inferior Outcome in Patients With Diffuse Large B-Cell Lymphoma

et al. 2021

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The prognostic value of albumin changes between diagnosis and end-of-treatment (EoT) in diffuse large B-cell lymphoma (DLBCL) remains unknown. We retrospectively analyzed 574 de novo DLBCL patients treated with R-CHOP from our and two other centers. All patients were divided into a training cohort (n = 278) and validation cohort (n = 296) depending on the source of the patients. Overall survival (OS) and progression-free survival (PFS) were analyzed by the method of Kaplan–Meier and Cox proportional hazard regression model. In the training cohort, 163 (58.6%) patients had low serum albumin at diagnosis, and 80 of them were present with consecutive hypoalbuminemia at EoT. Patients with consecutive hypoalbuminemia showed inferior OS and PFS (p = 0.010 and p = 0.079, respectively). Similar survival differences were also observed in the independent validation cohort (p = 0.006 and p = 0.030, respectively). Multivariable analysis revealed that consecutive hypoalbuminemia was an independent prognostic factor OS [relative risk (RR), 2.249; 95% confidence interval (CI), 1.441–3.509, p < 0.001] and PFS (RR, 2.001; 95% CI, 1.443–2.773, p < 0.001) in all DLBCL patients independent of IPI. In conclusion, consecutive hypoalbuminemia is a simple and effective adverse prognostic factor in patients with DLBCL, which reminds us to pay more attention to patients with low serum albumin at EoT during follow-up.

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“…This study's retrospective nature, limited sample size, and lack of incorporation of other prognostic indicators [44][45][46][47] may have introduced bias, and thus the results should be interpreted with caution. Nevertheless, considering the curability of DLBCL, the frequency of TP53 mutations in DLBCL, and the proportion of primary refraction, we believe our findings could provide some hints for optimizing treatment for TP53 mut DLBCL.…”

Section: Discussionmentioning

confidence: 99%

<p>Characteristics and Management of <em>TP53</em>-Mutated Diffuse Large B-Cell Lymphoma Patients</p>

Qin¹,

Jiang²,

Liu³

et al. 2020

CMAR

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Background/Aim TP53 mutation is recognized as a negative prognostic factor for patients with diffuse large B-cell lymphoma (DLBCL). Here, we present the characteristics of TP53 mut DLBCL patients following investigation of the effect of a treatment approach on survival of TP53 mut DLBCL patients. Methods A total of 44 DLBCL patients with TP53 mut and treated with an R-CHOP regimen were included for analysis. Patients who failed to achieve a complete response (CR) to initial treatment or relapsed in the first 6 months after initial CR were deemed to have primary refractory disease. Results Among 44 patients harboring TP53 mutations who underwent upfront R-CHOP or R-CHOP–like treatment, 21 (47.7%) had limited-stage and 23 (52.3%) presented advanced-stage disease. Apart from the seven patients receiving upfront surgical resection, 37 had measurable disease under the R-CHOP regimen, with 59.1% (n=26) developing primary refractory disease. Seven limited-stage patients after early complete resection and one with residue resection remained event-free at median follow-up of 37 months. Multivariate analysis revealed that elevated baseline lactate dehydrogenase (LDH), extranodal involvement (two or more), Ann Arbor stage, and locoregional treatment (surgery or radiation therapy) were independent indicators for progression-free survival (PFS). After adjustment for baseline LDH and extranodal involvement, adding locoregional treatment including surgery and radiation to the R-CHOP regimen significantly improved PFS ( p =0.008) and overall survival ( p =0.017) in limited-stage TP53 mut DLBCL patients compared to R-CHOP–only treatment. Conclusion This study presents the characteristics of TP53 -mutated DLBCL and implies a potential benefit of locoregional treatment in limited-stage DLBCL patients with TP53 mutations.

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Cell‐of‐origin determined by both gene expression profiling and immunohistochemistry is the strongest predictor of survival in patients with diffuse large B‐cell lymphoma

Cited by 28 publications

References 40 publications

Advances in the Pathogenesis of EBV-Associated Diffuse Large B Cell Lymphoma

Advances in the Pathogenesis of EBV-Associated Diffuse Large B Cell Lymphoma

Consecutive Hypoalbuminemia Predicts Inferior Outcome in Patients With Diffuse Large B-Cell Lymphoma

<p>Characteristics and Management of <em>TP53</em>-Mutated Diffuse Large B-Cell Lymphoma Patients</p>

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