Tang Huifen, Zhou Hui, Wei Juying, Liu Hui, Qian Wenbin, Chen Xiaohui
a Department of Hematology , The Affiliated Hospital, Hangzhou Normal University , Hangzhou , People's Republic of China.
b Department of Hematology , The First Affiliated Hospital, College of Medicine, Zhejiang University , Hangzhou , People's Republic of China.
Hematology. 2019 Dec;24(1):446-454. doi: 10.1080/16078454.2019.1614289.
Various subsets of diffuse large B-cell lymphoma(DLBCL) are distinguished based on molecular and immunohistochemical features. As we know, CD5 is a pan-T-cell surface marker and is seldom expressed in DLBCL. Large-scale studies of de novo CD5+ DLBCL are lacking in Chinese patients.
A total of 139 patients with DLBCL (30 CD5+ DLBCL and 109 CD5- DLBCL) who were immunophenotyped and treated with chemotherapy were subjected to this analysis. There were 85 males and 54 females. Their age ranged from 17 to 84 years old, and the median age was 58 years old.
In this study CD5+ DLBCL was associated with higher IPI scores (>2), bone marrow involvement, higher probability of >1 ECOG performance status, non-germinal center B-cell like(non-GCB), BCL2 overexpression, whereas seldom expressed CD10 or BCL6, and unconspicuous higher expression of Ki67. With standard chemotherapy, CD5+ DLBCL patients had significantly worse overall survival (OS, median, 29.5 months vs. not reached, P = 0.0004) and progression-free survival (PFS, median, 18.0 months vs. not reached, P = 0.0002) than CD5- DLBCL patients, which had independent prognostic significance of the International Prognostic Index (IPI), and subtype of the non-GCB DLBCL. For CD5+ DLBCL, the addition of rituximab to chemotherapy may not significantly improve the OS (median, 14 months vs. 29.5 months, P = 0.72) and PFS (median, 10 months vs. 12 months, P = 0.92).
CD5+ DLBCL patients have the distinctive clinical and biological features, they should be provided with clinic individualized treatment and important pathways with therapeutic implications should be underscored.
弥漫性大B细胞淋巴瘤（DLBCL）的不同亚群可根据分子和免疫组化特征进行区分。众所周知，CD5是一种泛T细胞表面标志物，在DLBCL中很少表达。中国患者中缺乏对初发性CD5+ DLBCL的大规模研究。
对139例接受免疫表型分析并接受化疗的DLBCL患者（30例CD5+ DLBCL和109例CD5- DLBCL）进行了该分析。其中男性85例，女性54例。年龄范围为17至84岁，中位年龄为58岁。
在本研究中，CD5+ DLBCL与较高的国际预后指数（IPI）评分（>2）、骨髓受累、ECOG体能状态>1的可能性较高、非生发中心B细胞样（non-GCB）、BCL2过表达相关，而CD10或BCL6很少表达，Ki67表达无明显升高。采用标准化疗时，CD5+ DLBCL患者的总生存期（OS，中位生存期29.5个月 vs. 未达到，P = 0.0004）和无进展生存期（PFS，中位生存期18.0个月 vs. 未达到，P = 0.0002）明显比CD5- DLBCL患者差，这对IPI及non-GCB DLBCL亚型具有独立的预后意义。对于CD5+ DLBCL，化疗中添加利妥昔单抗可能不会显著改善OS（中位生存期14个月 vs. 29.5个月，P = 0.72）和PFS（中位生存期10个月 vs. 12个月，P = 0.92）。
CD5+ DLBCL患者具有独特的临床和生物学特征，应给予临床个体化治疗，并强调具有治疗意义的重要途径。
