Addition of rituximab to chemotherapy overcomes the negative prognostic impact of cyclin E expression in diffuse large B-cell lymphoma

作者：Frei E; Visco C; Xu Monette Z Y; Dirnhofer S; Dybkaer K; Orazi A; Bhagat G; Hsi E D; van Krieken J H; Ponzoni M; Go R S; Piris M A; Moller M B; Young K H; Tzankov A^*

来源：Journal of Clinical Pathology, 2013, 66(11): 956-961.

DOI：10.1136/jclinpath-2013-201619

• Lymphoma
• Cell Cycle Regulation
• Haematopathology

Background High levels of cyclin E (CCNE) are accompanied by shorter survival in cyclophosphamide, hydroxydaunorubicin, oncovin and prednisone (CHOP)-treated diffuse large B-cell lymphomas (DLBCL), independent of the international prognostic index (IPI). Data on the prognostic role of CCNE in the rituximab (R)-era%26apos; are lacking. %26lt;br%26gt;Methods To test reproducibility and applicability of observations from the pre-R era%26apos; to the R era%26apos;, we examined the prognostic role of CCNE expression by immunohistochemistry in 1579 DLBCL on tissue microarrays (TMA); 339 patients were treated by CHOP and 635 by R-CHOP. %26lt;br%26gt;Results 1209 samples (77%) were evaluable; failures were due to missing TMA punches and fixation artefacts. Mean expression of CCNE was 13% (0-85%); applying a cut-off of %26gt;16%, 382 DLBCL (31%) were positive. CCNE did not correlate with any of the known variables (IPI, primary site, cell of origin, proliferation, and BCL2- or C-MYC rearrangements). We were able to reproduce data suggesting an IPI- and response to therapy independent, negative prognostic impact of CCNE in CHOP-treated DLBCL patients: CCNE-positive cases had a median survival of 16months compared with 57months in negative ones (p=0.012). In R-CHOP-treated patients the prognostic impact of CCNE was abrogated and only IPI, cell of origin and response to therapy had a prognostic significance. %26lt;br%26gt;Conclusions Addition of R to CHOP overcomes the negative prognostic impact of CCNE in DLBCL. Thus, R not only prolongs survival in DLBCL but also serves a cautionary note that prognostic factors should not be transferred into the R era%26apos; without proper scientific studies.

• 出版日期2013-11