Abstract
The aim of this study was to determine the clinical significances of p53 and p-glycoprotein (P-gp) expression on outcome predictors for patients with DLBC. We assessed the immunohistochemical expression of p53 and P-gp using formalin-fixed, paraffin-embedded specimens in 108 patients diagnosed with de novo DLBC. A high expression of p53 was found in 53.7% of the patients. No expression of P-gp was demonstrated in any of the specimens. There were no significant differences in the complete remission (CR) rate (P = 0.79), overall survival (OS) (P = 0.73), or disease-free survival (DFS) (P = 31) between the p53-positive and p53-negative groups. The final model from multivariate analysis that revealed poor performance status was significantly associated with CR (P < 0.001) and OS (P < 0.001). Moreover, the advanced stage was a significant predictor of DFS (P = 0.03). This study demonstrated no impact of the expression of p53 on either response or survival rates.
Highlights
Diffuse large B-cell lymphoma (DLBC) is the most common type of non-Hodgkin lymphoma (NHL) accounting for 50% of NHL in Thailand [1]
There were 122 DLBC patients diagnosed during the study period
The majority of patients were treated with CHOP chemotherapy
Summary
Diffuse large B-cell lymphoma (DLBC) is the most common type of non-Hodgkin lymphoma (NHL) accounting for 50% of NHL in Thailand [1]. The outcomes of treatment were markedly improved by adding rituximab to standard CHOP regimen (R-CHOP) [2], the 5-year event-free survival rate was only 47% [3]. Stratifying newly diagnosed patients according to risk will provide invaluable information to achieve the optimal risk-adapted strategy. Since the International Prognostic Index (IPI) was introduced in 1993, the strong prognostic predictability has been proved [4, 5]. Patients with high-risk IPI may be unsuitable for intensive therapy due to old age or poor performance status (PS). Additional prognostic factors reflecting tumor biology are needed to identify patients who might benefit from dose intensification or new targeted therapy
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