Abstract
Background: Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma and prognostic information is essential in finding the right treatment. This study evaluated the prognostic significance of Ki-67 in patients with DLBCL. Methods: Patients with DLBCL, treated with first-line R-CHOP, were retrospectively analyzed in groups of high (>70%) and low (≤70%) Ki-67. Parameters of interest were the international prognostic index (IPI), treatment response, progression-free survival (PFS) and overall survival (OS). A chi-squared test or Fisher’s exact test was conducted to analyze categorical variables. Kaplan–Meier and log-rank tests were applied for survival analyses. Finally, a multivariate linear regression analysis was performed, including gender, Ki-67 ≤ 70% or >70%, IPI and presence of B symptoms. Results: Overall, 58 patients were included. No significant association was found between Ki-67 status and IPI (p = 0.148) or treatment response (p = 0.373). Survival in patients with high Ki-67 was significantly inferior with respect to OS (p = 0.047) but not PFS (p = 0.138). Multivariate linear regression, however, yielded only IPI as a risk factor for OS. Conclusion: Future studies with larger patient cohorts are needed in order to elucidate the prognostic role of Ki-67 in patients with DLBCL treated with R-CHOP.
Highlights
Diffuse large B-cell lymphoma (DLBCL) accounts for approximately 25–35% of nonHodgkin lymphomas (NHL) [1] and, despite continuous research for new and better therapies, R-CHOP is still considered the standard first-line therapy [2,3]
In DLBCL, some studies found high Ki-67 expression to be associated with inferior event-free survival (EFS), progression-free survival (PFS) and overall survival (OS) [5,6,7,8], as well as a higher international prognostic index (IPI) [9]
It was found that high Ki-67 expression is more common in non-germinal-center B-cell-like DLBCL and is associated with c-MYC expression, which might partly explain the poorer outcome in those patients [16]
Summary
Diffuse large B-cell lymphoma (DLBCL) accounts for approximately 25–35% of nonHodgkin lymphomas (NHL) [1] and, despite continuous research for new and better therapies, R-CHOP is still considered the standard first-line therapy [2,3]. In DLBCL, some studies found high Ki-67 expression to be associated with inferior event-free survival (EFS), progression-free survival (PFS) and overall survival (OS) [5,6,7,8], as well as a higher international prognostic index (IPI) [9]. The present single-center retrospective cohort study aims to evaluate the prognostic significance of Ki-67 in patients treated with R-CHOP on progression-free survival (PFS) and overall survival (OS). Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma and prognostic information is essential in finding the right treatment. Methods: Patients with DLBCL, treated with first-line R-CHOP, were retrospectively analyzed in groups of high (>70%) and low (≤70%) Ki-67. Parameters of interest were the international prognostic index (IPI), treatment response, progression-free survival (PFS) and overall survival (OS). Conclusion: Future studies with larger patient cohorts are needed in order to elucidate the prognostic role of Ki-67 in patients with DLBCL treated with R-CHOP
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