Department of Lymphoma, Sino-US Center for Lymphoma and Leukemia, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Tianjin, People's Republic of China.
Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Tianjin, People's Republic of China.
Hematol Oncol. 2019 Oct;37(4):360-367. doi: 10.1002/hon.2657. Epub 2019 Sep 12.
De novo CD5-positive diffuse large B-cell lymphoma (CD5+ DLBCL) is increasingly recognized as a distinct pathologic phenomenon with a specific clinical picture. However, CD5+ DLBCL has not been studied on a large scale in China. In this study, we show that CD5+ DLBCL occurs at a low frequency (9.2%). Comparison of clinical characteristics of CD5+ vs CD5- DLBCL showed that CD5+ DLBCL was more frequently elderly (>60 years) and had B symptoms, high-performance status, stage III-IV, an IPI score >2 and bone marrow involvement. Patients with CD5+ DLBCL had tumours with a higher prevalence of BCL-2 and p53 overexpression than CD5- DLBCL. Patients with CD5+ DLBCL had inferior progression-free survival (PFS) and overall survival (OS) than did patients with CD5- DLBCL. For CD5+ DLBCL, the patients who were treated with rituximab showed significantly better PFS and OS than those treated without rituximab. However, patients treated with RCHOP showed similar PFS and OS when compared with the group treated with intensive therapy. In addition, patients with p53 and CD5 co-expression had the worst PFS and OS. In conclusion, CD5+ DLBCL was associated with unfavorable clinicopathologic variables and with inferior survival. CD5+ DLBCL has a high frequency of p53 overexpression, and CD5 augments the negative effect of p53 overexpression in DLBCL.
CD5 阳性弥漫性大 B 细胞淋巴瘤（CD5+ DLBCL）是一种逐渐被认识到的独特病理现象，具有特定的临床表现。然而，在中国，尚未对 CD5+ DLBCL 进行大规模研究。在本研究中，我们表明 CD5+ DLBCL 的发生率较低（9.2%）。比较 CD5+ 与 CD5- DLBCL 的临床特征显示，CD5+ DLBCL 多见于老年人（>60 岁），并伴有 B 症状、高体能状态、III-IV 期疾病、国际预后指数（IPI）评分>2 和骨髓累及。CD5+ DLBCL 患者的肿瘤中 BCL-2 和 p53 过表达更为常见，而 CD5- DLBCL 则不然。与 CD5- DLBCL 患者相比，CD5+ DLBCL 患者的无进展生存期（PFS）和总生存期（OS）更差。对于 CD5+ DLBCL，接受利妥昔单抗治疗的患者的 PFS 和 OS 明显优于未接受利妥昔单抗治疗的患者。然而，与强化治疗组相比，接受 RCHOP 治疗的患者的 PFS 和 OS 相似。此外，p53 和 CD5 共表达的患者的 PFS 和 OS 最差。总之，CD5+ DLBCL 与不良的临床病理变量相关，并与较差的生存相关。CD5+ DLBCL 中 p53 过表达频率较高，CD5 增强了 p53 过表达在 DLBCL 中的负面效应。
