Cell of origin fails to predict survival in patients with diffuse large B‐cell lymphoma treated with autologous hematopoietic stem cell transplantation

Abstract

Diffuse large B-cell lymphoma (DLBCL) includes two prognostically-important subtypes, the germinal center B-cell (GCB) and the non-GCB types. The aim of this study was to evaluate immunohistochemical approaches for predicting the survival of patients with DLBCL following autologous hematopoietic stem cell transplantation (AHSCT). We identified 62 patients with DLBCL who either had an initial complete remission (17 patients) or received salvage chemotherapy for relapsed or refractory disease (45 patients), followed by AHSCT. Tissue microarrays were immunostained with monoclonal antibodies against GCET1, CD10, BCL6, MUM1, FOXP1 and LMO2. Using the Hans algorithm, we classified 50% of the cases as GCB type, whereas the Choi algorithm classified 58% as GCB type and LMO2 was positive in 69%. However, no significant differences were found in the five-year overall or event-free survivals using any of these approaches. In conclusion, cell-of-origin fails to predict survival of DLBCL patients treated with AHSCT.

Upfront Consolidation Combining Yttrium-90 Ibritumomab Tiuxetan and High-Dose Therapy with Stem Cell Transplantation in Poor-Risk Patients with Diffuse Large B Cell Lymphoma

“…Intensified chemotherapy with rituximab possibly improves survival in younger patients with nongerminal DLBCL compared with standard R-CHOP [37]. In a retrospective study of patients with DLBCL treated with ACST as first-line therapy, Gu et al suggested that the cell of origin fails to predict survival [38]. The prognostic relevance of BCL2 is more complex.…”

Molecular Profile and FDG-PET/CT Total Metabolic Tumor Volume Improve Risk Classification at Diagnosis for Patients with Diffuse Large B-Cell Lymphoma

“…The other methods to determine COO, or MYC and BCL2 expressions such as IHC have their own limitations. For instance, in some studies, non-GCB phenotype do not correlate with bad prognosis (30)(31)(32) as confirmed by a recent meta-analysis (33) and concordance between IHC and GEP is imperfect (34). Even though concurrent overexpression of both MYC and BCL2 had been associated with a poor outcome in several studies (18,35), the recent European Society for Medical Oncology consensus (36) does not yet recommended changing therapeutic strategy according to these results due to problems in reproducibility of manual or visual IHC scoring and lack of agreement on the optimal positivity thresholds throughout the laboratories.…”

MYC/BCL2 protein coexpression contributes to the inferior survival of activated B-cell subtype of diffuse large B-cell lymphoma and demonstrates high-risk gene expression signatures: a report from The International DLBCL Rituximab-CHOP Consortium Program

“…[4][5][6][7][8][9][10] The results, however, have been controversial as the concordance with GEP results is imperfect to varying degrees and, in some studies, IHC results do not correlate with prognosis. [11][12][13] Furthermore, both the GCB and ABC subtypes of DLBCL as defined by GEP are heterogeneous and contain biological subgroups that have different prognoses and may require different therapeutic approaches. Therefore, a stratification of DLBCL patients into subgroups that are biologically homologous and prognostically meaningful, and that are more predictive than the overall categories of GCB and ABC is needed, thereby facilitating therapeutic decisions.…”