Nyman Heidi, Adde Magdalena, Karjalainen-Lindsberg Marja-Liisa, Taskinen Minna, Berglund Mattias, Amini Rose-Marie, Blomqvist Carl, Enblad Gunilla, Leppä Sirpa
Department of Oncology, Helsinki University Central Hospital, FIN-00029 Helsinki, Finland.
Blood. 2007 Jun 1;109(11):4930-5. doi: 10.1182/blood-2006-09-047068. Epub 2007 Feb 13.
Germinal center (GC) and non-GC phenotypes are predictors of outcome in diffuse large B-cell lymphoma (DLBCL) and can be used to stratify chemotherapy-treated patients into low- and high-risk groups. To determine how combination of rituximab with chemotherapy influences GC-associated clinical outcome, GC and non-GC phenotypes were identified immunohistochemically from samples of 90 de novo DLBCL patients treated with rituximab in combination with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)-like regimen (immunochemotherapy). One hundred and four patients previously treated with chemotherapy served as a control group. Consistent with previous studies, chemotherapy-treated patients with immunohistochemically defined GC phenotype displayed a significantly better overall (OS) and failure-free survival (FFS) than the non-GC group (OS, 70% vs 47%, P = .012; FFS, 59% vs 30%, P = .001). In contrast, immunohistochemically defined GC phenotype did not predict outcome in immunochemotherapy-treated patients (OS, 77% vs 76%, P = ns; FFS, 68% vs 63%, P = ns). In comparison, International Prognostic Index (IPI) could separate the high-risk patients from low- and intermediate-risk groups (OS, 84% vs 63%, P = .030; FFS, 79% vs 52%, P = .028). We conclude that rituximab in combination with chemotherapy seems to eliminate the prognostic value of immunohistochemically defined GC- and non-GC phenotypes in DLBCL.
生发中心（GC）和非GC表型是弥漫性大B细胞淋巴瘤（DLBCL）预后的预测指标，可用于将接受化疗的患者分为低风险和高风险组。为了确定利妥昔单抗与化疗联合使用如何影响与GC相关的临床结果，从90例接受利妥昔单抗联合CHOP（环磷酰胺、阿霉素、长春新碱和泼尼松）类方案（免疫化疗）治疗的初治DLBCL患者的样本中，通过免疫组织化学鉴定GC和非GC表型。104例先前接受过化疗的患者作为对照组。与先前的研究一致，免疫组织化学定义为GC表型的化疗患者的总生存期（OS）和无失败生存期（FFS）明显优于非GC组（OS，70%对47%，P = 0.012；FFS，59%对30%，P = 0.001）。相比之下，免疫组织化学定义的GC表型并不能预测接受免疫化疗患者的预后（OS，77%对76%，P = 无显著性差异；FFS，68%对63%，P = 无显著性差异）。相比之下，国际预后指数（IPI）可以将高风险患者与低风险和中风险组区分开来（OS，84%对63%，P = 0.030；FFS，79%对52%，P = 0.028）。我们得出结论，利妥昔单抗与化疗联合使用似乎消除了免疫组织化学定义的GC和非GC表型在DLBCL中的预后价值。
