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Prognostic impact of CD 5 expression in diffuse large B‐cell lymphoma in patients treated with rituximab‐ EPOCH
Author(s) -
Thakral Beenu,
Medeiros L. Jeffrey,
Desai Parth,
Lin Pei,
Yin C. Cameron,
Tang Guilin,
Khoury Joseph D.,
Hu Shimin,
Xu Jie,
Loghavi Sanam,
Hu Bei,
Oki Yasuhiro,
Li Shaoying
Publication year - 2017
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12847
Subject(s) - cd5 , diffuse large b cell lymphoma , epoch (astronomy) , rituximab , lymphoma , bcl6 , medicine , oncology , international prognostic index , b symptoms , cancer research , gastroenterology , immunology , b cell , antibody , physics , astronomy , stars , germinal center
Objectives CD 5‐positive ( CD 5+) diffuse large B‐cell lymphoma ( DLBCL ) represents 5%‐10% of all DLBCL cases, which has been associated with a poorer prognosis in patients treated with R‐ CHOP . Prognostic impact of CD 5 expression in patients with DLBCL treated with R‐ EPOCH has not been evaluated. Methods We studied 130 patients with de novo DLBCL who received frontline R‐ EPOCH therapy. The clinicopathologic features and overall survival ( OS ) were compared between patients with CD 5+ and CD 5‐ DLBCL . MYC , BCL 2, and BCL 6 rearrangements were examined by fluorescent in situ hybridization. Results Sixteen (12.3%) of 130 DLBCL s were CD 5+. Most clinicopathologic features including cell of origin and frequency of MYC , BCL 2 , and BCL 6 rearrangements were similar between CD 5+ and CD 5− groups. Patients with CD 5+ DLBCL , however, showed higher rate of central nervous system relapse (33.3% vs 15.6%; P <.01) and a higher Ki67 proliferative index compared with CD 5‐ patients. The median OS was significantly worse in CD 5+ than CD 5‐ patients (28.13 months vs not reached, P =.006). CD 5 expression was an independent prognostic factor for OS in multivariate analysis. Conclusions R‐ EPOCH therapy does not seem to impact the known poorer prognosis of patients with de novo CD 5+ DLBCL , and CD 5 expression was still an independent prognostic factor in R‐ EPOCH ‐treated patients with DLBCL .