Wilson Kenneth S, Sehn Laurie H, Berry Brian, Chhanabhai Mukesh, Fitzgerald Catherine A, Gill Karamjit K, Klasa Richard, Skinnider Brian, Sutherland Judy, Connors Joseph M, Gascoyne Randy D
Department of Medical Oncology, Vancouver Island Centre, University of British Columbia, BC, Canada.
Leuk Lymphoma. 2007 Jun;48(6):1102-9. doi: 10.1080/10428190701344881.
BCL-2 protein expression correlates with shorter survival in patients with diffuse large B cell lymphoma (DLBCL) who are treated with CHOP chemotherapy. We report a retrospective analysis of the prognostic significance of BCL-2 status in patients who received CHOP with the addition of rituximab (CHOP-R) for DLBCL. Patients over 15 years of age with de novo, HIV negative DLBCL, without CNS involvement, and known BCL-2 protein status were identified from the BCCA Lymphoid Cancer Database. BCL-2 tumour positivity was defined as over 50% of tumour cells with BCL-2 protein expression. 140 patients who received CHOP-R were analysed. The majority (59%) of patients were over 60 years of age. Disease stage distribution was limited (22%) and advanced (78%). BCL-2 protein expression was observed in 90 (64%) cases. IPI score was similar in both BCL-2 positive and negative cases. Median follow-up time for living patients is 40 months. BCL-2 status did not predict for either progression-free or overall survival. IPI score was predictive for progression-free survival but not overall survival. The addition of rituximab to CHOP chemotherapy negates the adverse prognostic influence of BCL-2 protein expression on progression free and overall survival in DLBCL.
在接受CHOP化疗的弥漫性大B细胞淋巴瘤（DLBCL）患者中，BCL-2蛋白表达与较短的生存期相关。我们报告了一项关于接受CHOP联合利妥昔单抗（CHOP-R）治疗DLBCL患者的BCL-2状态预后意义的回顾性分析。从BCCA淋巴瘤数据库中识别出年龄超过15岁、初发、HIV阴性、无中枢神经系统受累且已知BCL-2蛋白状态的DLBCL患者。BCL-2肿瘤阳性定义为超过50%的肿瘤细胞有BCL-2蛋白表达。对140例接受CHOP-R治疗的患者进行了分析。大多数（59%）患者年龄超过60岁。疾病分期分布为局限期（22%）和晚期（78%）。90例（64%）病例观察到BCL-2蛋白表达。BCL-2阳性和阴性病例的国际预后指数（IPI）评分相似。存活患者的中位随访时间为40个月。BCL-2状态对无进展生存期或总生存期均无预测作用。IPI评分对无进展生存期有预测作用，但对总生存期无预测作用。CHOP化疗联合利妥昔单抗消除了BCL-2蛋白表达对DLBCL无进展生存期和总生存期的不良预后影响。
