Diffuse large B‐cell lymphoma in the young in Japan: A study by the Osaka Lymphoma Study Group

Abstract

Clinicopathological and immunophenotypical characteristics in 24 patients with diffuse large B-cell lymphoma (DLBCL) under 30 years of age in Osaka, Japan were examined, and the results compared to those of DLBCL patients aged over 40 years in Osaka and of young DLBCL patients in Western countries. The level of LDH and IPI score at initial diagnosis were significantly lower in young than older patients. The sex ratio (M:F) and age range (median) in the young and older groups were 1.18 and 11-30 (24.8) years and 1.59 and 42-87 (62.4) years, respectively. Extranodal presentation was higher in the young group (83.3% versus 60.0%, P < 0.05). Based on immunophenotyping with anti-CD10, bcl-6, and MUM1 antibodies, the cases were categorized as germinal center B-cell (GCB) (CD10+ or CD10-, bcl-6+, MUM1+) or non-GCB phenotype. The frequency of GCB type was significantly lower in the young group than older group (25% vs. 54%, P < 0.05), and much lower than that reported for young patients in Western countries. In situ hybridization revealed one of the young patients to be positive for Epstein-Barr virus (EBV). In the older group, none of 31 cases showed EBV positivity. Three year event-free and overall survival rates of young patients were better than those of the older patients, although not significantly different. DLBCL in the young in Japan is characterized by a much lower frequency of the GCB phenotype compared to that in Western countries. Am. J. Hematol. 82:893-897, 2007. V

Differences in germinal centre and non-germinal center phenotype in gastric and intestinal diffuse large B-cell lymphomas

“…Immunohistochemical methods can best be considered a surrogate for molecular classification, with concordance rates ranging from 70 to 80%. Current evidence regarding the prognostic utility of this classification scheme is conflicting, particularly when rituximab is included in the chemotherapeutic regimen [6][7][8].…”

Germinal-center type B-cell classification and clinical characteristics of Chinese pediatric diffuse large B-cell lymphoma: a report of 76 cases

“…According to previous studies, the proportion of GCB subtype disease was 30% in Asian patients[30] and 22.1% in Chinese adult DLBCL patients[31], both of which were signi-ficantly lower than that observed in Western adult patients (50%)[30]. Additionally, this proportion in Japanese patients younger than 30 years (25%) was also relatively low[32]. The proportion of GCB subtype disease in Chinese patients (75%) has only been reported in one study that included 8 DLBCL patients younger than 13 years[33].…”

Nodular pattern of bone marrow infiltration: frequent finding in immunosuppression-related EBV-associated large B-cell lymphomas

“…Bone marrow involvement by DLBCL is less common than low grade B-NHL and occurs in 8-35% of cases [2,3,[8][9][10][11][12][13]. However, EBV-associated DLBCL, which represent a small subset of DLBCL (8-12%) [10,[20][21][22][23][24] were shown to have a slightly greater proclivity for the BM (39%) in a recent study [10], compared to EBV − DLBCL.…”

“…The frequency of BM involvement by B-NHL varies according to disease subtype. Marrow infiltration is more commonly observed in patients with low grade B-NHL, ranging from 30% for marginal zone lymphomas to virtually 100% for chronic lymphocytic leukemias [2][3][4][5][6][7], compared to diffuse large B cell lymphomas (DLBCL; 8-35%) [2,3,[8][9][10][11][12][13]. Differences in the frequency of BM involvement by DLBCL, with regard to their phenotype or association with Epstein-Barr virus (EBV) infection, are currently unclear.…”