IMMUNOHISTOCHEMISTRY BIOMARKERS IN PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA: A RETROSPECTIVE STUDY
(Abstract release date: 05/18/17)
EHA Library. Gaspar Brandao de Sousa e Sant . 05/18/17; 182449; PB1735
Dr. Paula Cristina Gaspar Brandao de Sousa e Sant
Contributions
Contributions
Abstract
Abstract: PB1735
Type: Publication Only
Background
Diffuse Large B-Cell Lymphoma (DLBCL) is a heterogeneous disease with variable clinical course. The International Prognostic Index (IPI) is the most important tool to identify subgroups with different survival, however, certain biological markers seem to have a prognostic value relevant and independent of IPI.
Aims
To analyze the evolution of patients diagnosed with DLBCL and the expression of BCL2, BCL6 and MYC.
Methods
We conducted a retrospective study that included hospitalized patients with de novo CD20+ DLBCL, with expression of BCL2+, BCL6+, BCL2/BCL6, MYC/BCL2, MYC/BCL6 treated with regimens containing rituximab, from February 2012 to November 2016. Samples were analyzed by immunohistochemistry. Statistical analysis with the SPSS V17.0 program.
Results
We included 43 patients with a median age of 65 years (22-87), 59.5% male, 45,2% had IPI 0-2, 54,8% had IPI 3-5, 26,2% stage I-II, 73,8% stage III-IV, 61,9% had extranodal disease and 23,8% bulky disease. Ki-67 was elevated in all patients who did this evaluation (n=28). In 13 patients was identified BCL2+, BCL6+ in 6, and 21 patients had co-expression of BCL2/BCL6, 1 patient had MYC/BCL2 and 1 had MYC/BCL6. The R-CHOP regimen was first line treatment in 92,8% of patients. The ORR was 82,5%, with 65% of CR, 15% PR and 17,5% PD. Of those patients who received second line treatment, 8 expressed BCL2/BCL6, 4 BCL2, 2 BCL6, 1 MYC/BCL2, and 1 MYC/BCL6. Of the 5 patients who had third line treatment 3 expressed BCL2/BCL6, 1 BCL2, and 1 MYC/BCL6. The average time to next treatment (TNT) was 5,2 months (0,5-19) for second line and 4,9 for third line. Mortality rate was 45,2%. With a median follow up of 18,6 months (3-58,6), the overall survival was 24,6 months (3-62).
Conclusion
The identification of biomarkers by immunohistochemistry is a relatively inexpensive process, which, when well elaborated and interpreted, allows to find in a safe way, subgroups of patients at high risk, who benefit from more aggressive 1st line therapy and, whenever possible, from the Inclusion in clinical trials with new drugs.
Session topic: 20. Aggressive Non-Hodgkin lymphoma - Clinical
Keyword(s): prognosis, Immunohistochemistry, Diffuse large B cell lymphoma
Abstract: PB1735
Type: Publication Only
Background
Diffuse Large B-Cell Lymphoma (DLBCL) is a heterogeneous disease with variable clinical course. The International Prognostic Index (IPI) is the most important tool to identify subgroups with different survival, however, certain biological markers seem to have a prognostic value relevant and independent of IPI.
Aims
To analyze the evolution of patients diagnosed with DLBCL and the expression of BCL2, BCL6 and MYC.
Methods
We conducted a retrospective study that included hospitalized patients with de novo CD20+ DLBCL, with expression of BCL2+, BCL6+, BCL2/BCL6, MYC/BCL2, MYC/BCL6 treated with regimens containing rituximab, from February 2012 to November 2016. Samples were analyzed by immunohistochemistry. Statistical analysis with the SPSS V17.0 program.
Results
We included 43 patients with a median age of 65 years (22-87), 59.5% male, 45,2% had IPI 0-2, 54,8% had IPI 3-5, 26,2% stage I-II, 73,8% stage III-IV, 61,9% had extranodal disease and 23,8% bulky disease. Ki-67 was elevated in all patients who did this evaluation (n=28). In 13 patients was identified BCL2+, BCL6+ in 6, and 21 patients had co-expression of BCL2/BCL6, 1 patient had MYC/BCL2 and 1 had MYC/BCL6. The R-CHOP regimen was first line treatment in 92,8% of patients. The ORR was 82,5%, with 65% of CR, 15% PR and 17,5% PD. Of those patients who received second line treatment, 8 expressed BCL2/BCL6, 4 BCL2, 2 BCL6, 1 MYC/BCL2, and 1 MYC/BCL6. Of the 5 patients who had third line treatment 3 expressed BCL2/BCL6, 1 BCL2, and 1 MYC/BCL6. The average time to next treatment (TNT) was 5,2 months (0,5-19) for second line and 4,9 for third line. Mortality rate was 45,2%. With a median follow up of 18,6 months (3-58,6), the overall survival was 24,6 months (3-62).
Conclusion
The identification of biomarkers by immunohistochemistry is a relatively inexpensive process, which, when well elaborated and interpreted, allows to find in a safe way, subgroups of patients at high risk, who benefit from more aggressive 1st line therapy and, whenever possible, from the Inclusion in clinical trials with new drugs.
Session topic: 20. Aggressive Non-Hodgkin lymphoma - Clinical
Keyword(s): prognosis, Immunohistochemistry, Diffuse large B cell lymphoma
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