Abstract
ABSTRACTBackground: Various subsets of diffuse large B-cell lymphoma(DLBCL) are distinguished based on molecular and immunohistochemical features. As we know, CD5 is a pan-T-cell surface marker and is seldom expressed in DLBCL. Large-scale studies of de novo CD5+ DLBCL are lacking in Chinese patients.Method: A total of 139 patients with DLBCL (30 CD5+ DLBCL and 109 CD5− DLBCL) who were immunophenotyped and treated with chemotherapy were subjected to this analysis. There were 85 males and 54 females. Their age ranged from 17 to 84 years old, and the median age was 58 years old.Results: In this study CD5+ DLBCL was associated with higher IPI scores (>2), bone marrow involvement, higher probability of >1 ECOG performance status, non-germinal center B-cell like(non-GCB), BCL2 overexpression, whereas seldom expressed CD10 or BCL6, and unconspicuous higher expression of Ki67. With standard chemotherapy, CD5+ DLBCL patients had significantly worse overall survival (OS, median, 29.5 months vs. not reached, P = 0.0004) and progression-free survival (PFS, median, 18.0 months vs. not reached, P = 0.0002) than CD5− DLBCL patients, which had independent prognostic significance of the International Prognostic Index (IPI), and subtype of the non-GCB DLBCL. For CD5+ DLBCL, the addition of rituximab to chemotherapy may not significantly improve the OS (median, 14 months vs. 29.5 months, P = 0.72) and PFS (median, 10 months vs. 12 months, P = 0.92).Conclusion: CD5+ DLBCL patients have the distinctive clinical and biological features, they should be provided with clinic individualized treatment and important pathways with therapeutic implications should be underscored.
Highlights
DLBCL is one of the most common subtypes of mature B-cell neoplasms, which constitutes about 40% of the Non-Hodgkin lymphoma(NHL) [1]
Comparison of the clinical characteristics of CD5+ vs. CD5− DLBCL patients in this study showed that CD5+ DLBCL patients were more frequently with higher International Prognostic Index (IPI) scores (>2), bone marrow involvement, higher probability of >1 ECOG performance status (P < 0.05), and it seemed to be the tendency of women to dominate (Table 1)
There was no significant difference between the two groups in age, sex, B-symptoms, lactate dehydrogenase (LDH) level, number of extranodal site and central nervous system (CNS) involvement, which were inconsistent to previous reports
Summary
DLBCL is one of the most common subtypes of mature B-cell neoplasms, which constitutes about 40% of the Non-Hodgkin lymphoma(NHL) [1]. Since accumulating studies have gradually clarified that de novo CD5 positive (CD5+) DLBCL constitutes a unique subgroup which is different from non-GCB subtype and the germinal center B-cell-like (GCB) subtype on immunophenotypic features [3]. CD5 inhibits signaling downstream of the BCR pathway, including the calcium response and interleukin-2 (IL2) production whereas augments BCR-mediated IL10 productions, an anti-inflammatory cytokine and a survival factor for B-cells [4,5,6]. This molecular basis may explain in part why de novo CD5+ DLBCL shows more aggressive clinical features than CD5− DLBCL. Conclusion: CD5+ DLBCL patients have the distinctive clinical and biological features, they should be provided with clinic individualized treatment and important pathways with therapeutic implications should be underscored
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call