Immunohistochemical Methods for Predicting Cell of Origin and Survival in Patients With Diffuse Large B-Cell Lymphoma Treated With Rituximab

• Published in: Journal of clinical oncology Vol. 29; no. 2; pp. 200 - 207
• Main Authors: Meyer, Paul N., Fu, Kai, Greiner, Timothy C., Smith, Lynette M., Delabie, Jan, Gascoyne, Randy D., Ott, German, Rosenwald, Andreas, Braziel, Rita M., Campo, Elias, Vose, Julie M., Lenz, Georg, Staudt, Louis M., Chan, Wing C., Weisenburger, Dennis D.
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Society of Clinical Oncology 10.01.2011
• Subjects: Algorithms; Antibodies; Antibodies, Monoclonal, Murine-Derived - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; B-cell lymphoma; Biological and medical sciences; Cell survival; Cyclophosphamide; Cyclophosphamide - administration & dosage; Data processing; Doxorubicin; Doxorubicin - administration & dosage; Hematologic and hematopoietic diseases; Humans; Immunohistochemistry; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphocytes B; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - pathology; Medical sciences; Original Reports; Prednisone; Prednisone - administration & dosage; Rituximab; Survival Rate; Tumors; Vincristine; Vincristine - administration & dosage; Antineoplastic agent; Human; Immunohistochemistry; Cell survival; Rituximab; B cell neoplasm; Malignant hemopathy; Monoclonal antibody; Method; Non Hodgkin lymphoma; Anatomic pathology; Cancerology; Treatment; Lymphoproliferative syndrome; Immunotherapy; Diffuse large B cell lymphoma; Cancer; Cell origin
• ISSN: 0732-183X; 1527-7755; 1527-7755
• DOI: 10.1200/JCO.2010.30.0368

Patients with diffuse large B-cell lymphoma (DLBCL) can be divided into prognostic groups based on the cell of origin of the tumor as determined by microarray analysis. Various immunohistochemical algorithms have been developed to replicate these microarray results and/or stratify patients according to survival. This study compares some of those algorithms and also proposes some modifications. Two-hundred and sixty-two cases of de novo DLBCL treated with rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP-like therapy were examined. The Choi algorithm and Hans algorithm had high concordance with the microarray results. Modifications of the Choi and Hans algorithms for ease of use still retained high concordance with the microarray results. Although the Nyman and Muris algorithms had high concordance with the microarray results, each had a low value for either sensitivity or specificity. The use of LMO2 alone showed the lowest concordance with the microarray results. A new algorithm (Tally) using a combination of antibodies, but without regard to the order of examination, showed the greatest concordance with microarray results. All of the algorithms divided patients into groups with significantly different overall and event-free survivals, but with different hazard ratios. With the exception of the Nyman algorithm, this survival prediction was independent of the International Prognostic Index. Although the Muris algorithm had prognostic significance, it misclassified a large number of cases with activated B-cell type DLBCL. The Tally algorithm showed the best concordance with the microarray data while maintaining prognostic significance and ease of use.