Title: Prognostic Significance of Bcl-2 and Bcl-6 Immunostaining in B-Cell Non-Hodgkin's Lymphoma
Abstract:Purpose: The aim of this study was to identify a possible effect of Bcl-2 and Bcl-6 proteins on the clinical behavior and outcome in different subtypes of B-cell non-Hodgkin lymphoma (B-NHL). Methods:...Purpose: The aim of this study was to identify a possible effect of Bcl-2 and Bcl-6 proteins on the clinical behavior and outcome in different subtypes of B-cell non-Hodgkin lymphoma (B-NHL). Methods: We retrospectively studied Bcl-2 and Bcl-6 expression by immunohistochemistry (IHC) in 145 patients with diffuse large B-cell lymphoma (DLBCL), 86 patients with follicular lymphoma (FL), and 53 patients with mantle cell lymphoma (MCL), and analyzed their prognostic relevance and effect on treatment response in these cohorts.Results: Positive Bcl-2 expression related strongly to lower rates of complete response (CR) after first-line treatment with Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in both DLBCL (p=0.001) and MCL (p=0.01). Bcl-2 was recognized as an independent predictor of poor overall survival (OS) (HR=2.9, p<0.001, and HR=3.7, p= 0.02 in DLBCL and MCL, respectively). Patients with positive expression of Bcl-6 were more likely to achieve CR after R-CHOP in both DLBCL (p=0.006) and FL (p=0.012). Bcl-6 positive expression was an independent indicator of a favorable OS (HR=0.3, p<0.001, and HR=0.4, p=0.04 in DLBCL and FL, respectively). An IHC score based on the expression of Bcl-2 and Bcl-6 in DLBCL accurately defined three risk groups with markedly different OS (p<0.001). This new score outweighed the International Prognostic Index (IPI) as a prognostic indicator (HR=3.2 vs 2.2, p<0.001). Conclusion: Bcl-2 and Bcl-6 protein expression detected by IHC can be reliably used to help predict treatment response and survival trends in a wide subset of B-NHLs.Funding Information: None to declare. Declaration of Interests: The authors declare no competing financial interests.Ethics Approval Statement: This study was approved by the local ethics committee.Read More
Publication Year: 2021
Publication Date: 2021-01-01
Language: en
Type: article
Indexed In: ['crossref']
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