Evaluation of prognostic values of clinical and histopathologic characteristics in diffuse large B-cell lymphoma treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone therapy

Junshik Honga, Sanghui Parkb, Jinny Park*a, Hyung Sun Kima, Kyung-Hee Kimc, Jeong Yeal Ahnc, Min Young Rima, Minkyu Junga, Sun Jin Syma, Eun Kyung Choa, Dong Bok Shina & Jae Hoon Leeaa Departments of Internal Medicineb Pathologyc Laboratory Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, KoreaCorrespondence: Jinny Park, MD, Department of Internal Medicine, Gachon University Gil Hospital, 21 Namdongdae-ro 774-gil, Guwol 1-dong, Namdong-gu, Incheon, 405-760, Republic of Korea. Tel: +82-32-460-8209. Fax: +82-32-460-3233. E-mail: jhagnes@gilhospital.com *Two authors (Junshik Hong and Sanghui Park) contributed equally to this work and should be regarded as co-first authors.The relationship between histopathologic characteristics and treatment outcomes in patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab-based immunochemotherapy needs re-evaluation. Patients with newly diagnosed DLBCL treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) were evaluated with respect to clinical characteristics, treatment efficacy, and survival. Immunohistochemistry of bcl-2, CD10, bcl-6, and MUM-1 was performed and patients were sub-classified as germinal center B-cell-like (GCB) or non-GCB type according to the Hans algorithm. There was no significant difference in overall survival (OS) between patients with GCB and those with non-GCB. Although there was no significant difference in OS between high-intermediate and high risk groups as classified by the standard International Prognostic Index (IPI; p = 0.50), all three groups with the revised IPI had a clear-cut separation for event-free survival and OS. The revised IPI better predicted survival than did the standard IPI in patients with DLBCL treated with R-CHOP. The Hans classification had no prognostic value.