Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Ann Hematol. 2010 Feb;89(2):171-7. doi: 10.1007/s00277-009-0799-2. Epub 2009 Aug 11.
Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease with recognised variability in molecular aetiology and clinical outcome. Though the use of agents such as rituximab significantly improves outcome, intrinsic genetic and morphological factors greatly affect the response to treatment. The objective of this study was to evaluate the prognostic value of immunohistochemical subtyping and the International Prognostic Index (IPI) for predicting treatment outcome in Chinese DLBCL patients. We followed 108 cases of DLBCL and performed prognostic analyses based on molecular subtyping of the disease through immunostaining of tissue samples. The use of rituximab conferred a clinical benefit to DLBCL patients regardless of disease subtype. Importantly, this treatment regimen also improved outcomes in patients with the non-germinal centre B-cell-like (GCB) DLBCL subtype, frequently associated with poorer prognosis. Our results suggest that IPI was the best tool for the prediction of treatment outcome in our patient cohort, regardless of treatment regimen. Furthermore, the use of rituximab alongside classical chemotherapy regimens can improve the outcomes for DLBCL patients who exhibit both GCB and non-GCB subtypes of the disease.
弥漫性大 B 细胞淋巴瘤 (DLBCL) 是一种异质性疾病，其分子发病机制和临床结局存在可识别的变异性。尽管利妥昔单抗等药物的使用显著改善了预后，但内在的遗传和形态学因素极大地影响了治疗反应。本研究的目的是评估免疫组织化学亚型和国际预后指数 (IPI) 对中国 DLBCL 患者治疗结果的预测价值。我们随访了 108 例 DLBCL 患者，并通过对组织样本进行免疫染色来进行疾病的分子亚型预后分析。利妥昔单抗的使用为 DLBCL 患者带来了临床获益，无论疾病亚型如何。重要的是，这种治疗方案还改善了非生发中心 B 细胞样（GCB）DLBCL 亚型患者的预后，该亚型通常与预后较差相关。我们的结果表明，无论治疗方案如何，IPI 都是预测我们患者队列治疗结果的最佳工具。此外，在经典化疗方案中加入利妥昔单抗可以改善表现出 GCB 和非 GCB 疾病亚型的 DLBCL 患者的结局。
