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- Title
Comprehensive gene expression profiling and immunohistochemical studies support application of immunophenotypic algorithm for molecular subtype classification in diffuse large B-cell lymphoma: a report from the International DLBCL Rituximab-CHOP Consortium Program Study.
- Authors
Visco, C; Li, Y; Xu-Monette, Z Y; Miranda, R N; Green, T M; Li, Y; Tzankov, A; Wen, W; Liu, W-m; Kahl, B S; d'Amore, E S G; Montes-Moreno, S; Dybkær, K; Chiu, A; Tam, W; Orazi, A; Zu, Y; Bhagat, G; Winter, J N; Wang, H-Y; O'Neill, S; Dunphy, C H; Hsi, E D; Zhao, X F; Go, R S; Choi, W W L; Zhou, F; Czader, M; Tong, J; Zhao, X; van Krieken, J H; Huang, Q; Ai, W; Etzell, J; Ponzoni, M; Ferreri, A J M; Piris, M A; Møller, M B; Bueso-Ramos, C E; Medeiros, L J; Wu, L; Young, K H
- Abstract
Gene expression profiling (GEP) has stratified diffuse large B-cell lymphoma (DLBCL) into molecular subgroups that correspond to different stages of lymphocyte development-namely germinal center B-cell like and activated B-cell like. This classification has prognostic significance, but GEP is expensive and not readily applicable into daily practice, which has lead to immunohistochemical algorithms proposed as a surrogate for GEP analysis. We assembled tissue microarrays from 475 de novo DLBCL patients who were treated with rituximab-CHOP chemotherapy. All cases were successfully profiled by GEP on formalin-fixed, paraffin-embedded tissue samples. Sections were stained with antibodies reactive with CD10, GCET1, FOXP1, MUM1 and BCL6 and cases were classified following a rationale of sequential steps of differentiation of B cells. Cutoffs for each marker were obtained using receiver-operating characteristic curves, obviating the need for any arbitrary method. An algorithm based on the expression of CD10, FOXP1 and BCL6 was developed that had a simpler structure than other recently proposed algorithms and 92.6% concordance with GEP. In multivariate analysis, both the International Prognostic Index and our proposed algorithm were significant independent predictors of progression-free and overall survival. In conclusion, this algorithm effectively predicts prognosis of DLBCL patients matching GEP subgroups in the era of rituximab therapy.
- Publication
Leukemia, 2012, Vol 26, Issue 9, p2103
- ISSN
1476-5551
- Publication type
Journal Article
- DOI
10.1038/leu.2012.83