An integrated prognostic model for diffuse large B-cell lymphoma treated with immunochemotherapy

eJHaem

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Marta Rodríguez¹  Ruth Alonso-Alonso¹  Ismael Fernández-Miranda⁴  Rufino Mondéjar²  Laura Cereceda¹  Álvaro Tráscasa¹  Anabel Antonio-Da Conceiçao¹  Jennifer Borregón¹  Lucía Gato¹  Laura Tomás-Roca¹  Carmen Bárcena⁶  Begoña Iglesias⁷  Fina Climent⁸  Eva González-Barca⁹  Francisca Inmaculada Camacho^1,10  Émpar Mayordomo^1,11  Gabriel Olmedilla^1,12  Pilar Gómez-Prieto^1,13  Yolanda Castro^1,14  Juana Serrano-López^1,15  Joaquín Sánchez-García^1,16  Santiago Montes-Moreno²  Mónica García-Cosío²  Paloma Martín-Acosta²  Juan F. García²  María Planelles^2,21  Cristina Quero^2,22  Mariano Provencio^2,23  Ignacio Mahíllo-Fernández^2,24  Socorro M. Rodríguez-Pinilla¹  Enrico Derenzini^2,25  Stefano Pileri^2,25  Margarita Sánchez-Beato²  Raúl Córdoba²  Miguel A. Piris¹ 

[1] Pathology Department, IIS Hospital Universitario Fundación Jiménez Díaz;Center for Biomedical Network Research on Cancer;M. Rodríguez;Lymphoma Research Group;UGC Laboratorios, Hospital Universitario Puerto Real;Pathology Department, Hospital Universitario Doce de Octubre;Pathology Department, Hospital Álvaro Cunqueiro;Pathology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat;Haematology Department, Institut Català d'Oncologia, Hospital Duran i Reynals, L'Hospitalet de Llobregat;Pathology Department, Hospital Universitario de Getafe;Pathology Department, Hospital Universitario y Politécnico La Fe;Pathology Department, Hospital Universitario La Paz;Haematology Department, Hospital Universitario La Paz;Pathology Department, Hospital Universitario Príncipe de Asturias;Experimental Hematology Laboratory, IIS Hospital Universitario Fundación Jiménez Díaz;Haematology Department, Hospital Universitario Reina Sofia, Maimonides Biomedical Research Institute, IMIBIC, University of Córdoba;Pathology Department, Hospital Universitario Marqués de Valdecilla;Pathology Department, Hospital Universitario Ramón y Cajal;Pathology Department, Hospital Universitario Puerta de Hierro;Pathology Department, MD Anderson Cancer Center;Pathology Department, Hospital General Universitario de Alicante;Clinical Oncology Department, Hospital General Universitario Virgen de la Victoria, Complejo Hospital Costa del Sol;Clinical Oncology Department;Department of Epidemiology, IIS Hospital Universitario Fundación Jiménez Díaz;Divisions of Haemato-Oncology and Haematopathology, IEO European Institute of Oncology IRCCS;Haematology Department, IIS Hospital Universitario Fundación Jiménez Díaz

关键词: DLBCL;    gene expression;    immunochemotherapy;    diffuse large B-cell lymphoma;    prognosis;   

DOI  :  10.1002/jha2.457

来源: Wiley

【 摘 要 】

Diffuse large B-cell lymphoma (DLBCL), the most frequent non-Hodgkin's lymphoma subtype, is characterized by strong biological, morphological, and clinical heterogeneity, but patients are treated with immunochemotherapy in a relatively homogeneous way. Here, we have used a customized NanoString platform to analyze a series of 197 homogeneously treated DLBCL cases. The platform includes the most relevant genes or signatures known to be useful for predicting response to R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone) in DLBCL cases. We generated a risk score that combines the International Prognostic Index with cell of origin and double expression of MYC/BCL2 , and stratified the series into three groups, yielding hazard ratios from 0.15 to 5.49 for overall survival, and from 0.17 to 5.04 for progression-free survival. Group differences were highly significant ( p  < 0.0001), and the scoring system was applicable to younger patients (<60 years of age) and patients with advanced or localized stages of the disease. Results were validated in an independent dataset from 166 DLBCL patients treated in two distinct clinical trials. This risk score combines clinical and biological data in a model that can be used to integrate biological variables into the prognostic models for DLBCL cases.

【 授权许可】

Unknown