Thakral Beenu, Medeiros L Jeffrey, Desai Parth, Lin Pei, Yin C Cameron, Tang Guilin, Khoury Joseph D, Hu Shimin, Xu Jie, Loghavi Sanam, Hu Bei, Oki Yasuhiro, Li Shaoying
Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA.
Department of Lymphoma and Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA.
Eur J Haematol. 2017 Apr;98(4):415-421. doi: 10.1111/ejh.12847. Epub 2017 Jan 30.
CD5-positive (CD5+) diffuse large B-cell lymphoma (DLBCL) represents 5%-10% of all DLBCL cases, which has been associated with a poorer prognosis in patients treated with R-CHOP. Prognostic impact of CD5 expression in patients with DLBCL treated with R-EPOCH has not been evaluated.
We studied 130 patients with de novo DLBCL who received frontline R-EPOCH therapy. The clinicopathologic features and overall survival (OS) were compared between patients with CD5+ and CD5- DLBCL. MYC, BCL2, and BCL6 rearrangements were examined by fluorescent in situ hybridization.
Sixteen (12.3%) of 130 DLBCLs were CD5+. Most clinicopathologic features including cell of origin and frequency of MYC, BCL2, and BCL6 rearrangements were similar between CD5+ and CD5- groups. Patients with CD5+ DLBCL, however, showed higher rate of central nervous system relapse (33.3% vs 15.6%; P<.01) and a higher Ki67 proliferative index compared with CD5- patients. The median OS was significantly worse in CD5+ than CD5- patients (28.13 months vs not reached, P=.006). CD5 expression was an independent prognostic factor for OS in multivariate analysis.
R-EPOCH therapy does not seem to impact the known poorer prognosis of patients with de novo CD5+ DLBCL, and CD5 expression was still an independent prognostic factor in R-EPOCH-treated patients with DLBCL.
CD5阳性（CD5+）弥漫性大B细胞淋巴瘤（DLBCL）占所有DLBCL病例的5%-10%，这与接受R-CHOP治疗的患者预后较差有关。R-EPOCH治疗的DLBCL患者中CD5表达的预后影响尚未得到评估。
我们研究了130例接受一线R-EPOCH治疗的初治DLBCL患者。比较了CD5+和CD5-DLBCL患者的临床病理特征和总生存期（OS）。通过荧光原位杂交检测MYC、BCL2和BCL6重排。
130例DLBCL中有16例（12.3%）为CD5+。CD5+和CD5-组之间的大多数临床病理特征，包括起源细胞以及MYC、BCL2和BCL6重排的频率相似。然而，CD5+DLBCL患者的中枢神经系统复发率较高（33.3%对15.6%；P<0.01），与CD5-患者相比，Ki67增殖指数更高。CD5+患者的中位OS明显比CD5-患者差（28.13个月对未达到，P=0.006）。在多变量分析中，CD5表达是OS的独立预后因素。
R-EPOCH治疗似乎并未影响初治CD5+DLBCL患者已知的较差预后，并且CD5表达仍是接受R-EPOCH治疗的DLBCL患者的独立预后因素。
