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.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Visco, C; Li, Y; Xu-Monette, ZY; Miranda, RN; Green, TM; Tzankov, A; Wen, W; Liu, W-M; Kahl, BS; d'Amore, ESG; Montes-Moreno, S; Dybkær, K; Chiu, A; Tam, W; Orazi, A; Zu, Y; Bhagat, G; Winter, JN; Wang, H-Y; O'Neill, S; Dunphy, CH; Hsi, ED; Zhao, XF; Go, RS; Choi, WWL; Zhou, F; Czader, M; Tong, J; Zhao, X; van Krieken, JH; Huang, Q; Ai, W; Etzell, J; Ponzoni, M; Ferreri, AJM; Piris, MA; Møller, MB; Bueso-Ramos, CE; Medeiros, LJ; Wu, L; Young, KH

Published Date

  • September 2012

Published In

Volume / Issue

  • 26 / 9

Start / End Page

  • 2103 - 2113

PubMed ID

  • 22437443

Pubmed Central ID

  • PMC3637886

Electronic International Standard Serial Number (EISSN)

  • 1476-5551

Digital Object Identifier (DOI)

  • 10.1038/leu.2012.83


  • eng

Conference Location

  • England