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Prognostic significance of immunohistochemistry‐based markers and algorithms in immunochemotherapy‐treated diffuse large B cell lymphoma patients
Author(s) -
Culpin Rachel E,
Sieniawski Michal,
Angus Brian,
Me Geetha K,
Proctor Stephen J,
Milne Paul,
McCabe Kate,
MainouFowler Tryfonia
Publication year - 2013
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12223
Subject(s) - immunohistochemistry , medicine , diffuse large b cell lymphoma , gastroenterology , lymphoma , population , chop , cohort , algorithm , pathology , environmental health , computer science
Aims To reassess the prognostic validity of immunohistochemical markers and algorithms identified in the CHOP era in immunochemotherapy‐treated diffuse large B cell lymphoma patients. Methods and results The prognostic significance of immunohistochemical markers ( CD 10, B cl‐6, B cl‐2, MUM 1, K i‐67, CD 5, GCET 1, F ox P 1, LMO 2) and algorithms ( H ans, H ans*, M uris, C hoi, C hoi*, N yman, V isco‐ Y oung, T ally) was assessed using clinical diagnostic blocks taken from an unselected, population‐based cohort of 190 patients treated with R ‐ CHOP . Dichotomizing expression, low CD 10 (<10%), low LMO 2 (<70%) or high B cl‐2 (≥80%) predicted shorter overall survival ( OS ; P = 0.033, P = 0.010 and P = 0.008, respectively). High B cl‐2 (≥80%), low B cl‐6 (<60%), low GCET 1 (<20%) or low LMO 2 (<70%) predicted shorter progression‐free survival ( PFS ; P = 0.001, P = 0.048, P = 0.045 and P = 0.002, respectively). The H ans, H ans* and M uris classifiers predicted OS ( P = 0.022, P = 0.037 and P = 0.011) and PFS ( P = 0.021, P = 0.020 and P = 0.004). The C hoi, C hoi* and T ally were associated with PFS ( P = 0.049, P = 0.009 and P = 0.023). In multivariate analysis, the I nternational P rognostic I ndex ( IPI ) was the only independent predictor of outcome ( OS ; HR : 2.60, P < 0.001 and PFS ; HR : 2.91, P < 0.001). Conclusions Results highlight the controversy surrounding immunohistochemistry‐based algorithms in the R ‐ CHOP era. The need for more robust markers, applicable to the clinic, for incorporation into improved prognostic systems is emphasized.