Büyükkurt Nurhilal, Özcan Mehmet Ali, Ergene Ülkü, Payzın Bahriye, Tunalı Sunay, Demirkan Fatih, Özsan Hayri, Pişkin Özden, Ündar Bülent
Başkent University Faculty of Medicine, Adana Education and Research Centre, Clinic of Hematology, Adana, Turkey Phone: +90 322 327 27 27 E-mail:
Turk J Haematol. 2015 Jun;32(2):152-7. doi: 10.4274/tjh.2013.0367.
The curative treatment approach for diffuse large B-cell lymphoma (DLBCL) is controversial even in the rituximab (R) era. The aim of this study was to examine the FcγRIIIA gene polymorphism distribution of DLBCL patients who had been treated with R-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy. Furthermore, we investigated the impact of FcγRIIIA gene polymorphism on the overall response rate (ORR) and overall survival (OS).
Patients from 3 centers in the Aegean region of Turkey who had newly diagnosed CD20-positive DLBCL were enrolled in the study. The single nucleotide polymorphisms of the FcγRIIIA gene were analyzed by real time-PCR. The response to treatment was determined in the middle and at the end of the protocol. During 2 years of follow-up, the patients were clinically and radiologically evaluated for disease status every 3 months.
Thirty-six patients were included in the study and the distributions of F/F, V/F, and V/V types of alleles of FcγRIIIA were 25%, 50%, and 25%, respectively. Twenty-seven patients were considered as evaluable according to ORR and OS. The patients' ORR was 87.5%, 100%, and 50% in the F/F, V/F, and V/V allele groups, respectively. We did not establish any statistically significant differences among the 3 alleles groups in respect to ORR (p=0.93). The OS within 2 years in the F/F, V/F, and V/V allele groups was 62.5%, 100%, and 100%, respectively. The OS in the F/F allele group was found to be lower than in the other 2 allele groups (p=0.01).
The distribution of gene polymorphisms in our study group was similar to those of previous studies. While ORR was similar between the groups, our results highlight a lower OS in F/F patients compared to other allele groups of FcγRIIIA.
即使在利妥昔单抗（R）时代，弥漫性大B细胞淋巴瘤（DLBCL）的治疗方法仍存在争议。本研究旨在检测接受R-CHOP（环磷酰胺、阿霉素、长春新碱和泼尼松）化疗的DLBCL患者的FcγRIIIA基因多态性分布。此外，我们还研究了FcγRIIIA基因多态性对总缓解率（ORR）和总生存期（OS）的影响。
来自土耳其爱琴海地区3个中心的新诊断为CD20阳性DLBCL的患者纳入本研究。通过实时聚合酶链反应分析FcγRIIIA基因的单核苷酸多态性。在方案进行到中期和结束时确定治疗反应。在2年的随访期间，每3个月对患者进行临床和影像学评估以确定疾病状态。
36例患者纳入本研究，FcγRIIIA基因的F/F、V/F和V/V等位基因类型分布分别为25%、50%和25%。根据ORR和OS，27例患者被视为可评估对象。F/F、V/F和V/V等位基因组患者的ORR分别为87.5%、100%和50%。我们未发现3个等位基因组在ORR方面存在任何统计学显著差异（p = 0.93）。F/F、V/F和V/V等位基因组2年内的OS分别为62.5%、100%和100%。发现F/F等位基因组的OS低于其他2个等位基因组（p = 0.01）。
我们研究组的基因多态性分布与先前研究相似。虽然各组间ORR相似，但我们的结果表明，与FcγRIIIA的其他等位基因组相比，F/F患者的OS较低。
