PO-456 Prognostic significance of protein and gene expression of C-MYC, BCL-2, BCL-6 in diffuse large B-cell lymphoma determined by digital image analysis

Abstract

Introduction Due to its heterogeneity in appearance and clinical behaviour, numerous studies have attempted to further subclassify this object into significantly different groups. We determined the prognostic significance of immunohistochemical (IHC) and molecular markers (FISH probes) using digital pathology in patients with DBLC. Material and methods The study included data on 54 patients with diffuse large-cell B-cell lymphoma aged 18 to 77 years (mean age 50±15 years). In 46% of cases, localised forms of the disease were identified (stage I-II), 54% - the general stage (III-IV stage). As therapy, patients received 5–8 courses of chemotherapy R-CHOP. IHC parameters were assessed to diagnose DBCL: bcl-2, bcl-6, pax-5, CD5, CD3, CD19, CD20, CD30, CD10, Ki67. Hans algorithm was evaluated in 100% of cases. The subtype of the GCB was established in 43% of cases, and not in the GCB in 57%. We made FISH for BCL2, BCL6, C-MYC genes and estimated their prognostic value. All patients slides were quantified using computer quantitative IHC and FISH algorithms. The results were measured in terms of overall survival, response, or relapse after a complete response. Statistical analysis was carried out using the statistical software R. Results and discussions In the study group, 2 year survival without progression was 81% [95% CI 1.85–2.3]. Survival without progression was significantly lower in patients with B-symptoms (29% vs. 90%, OR 3.7 [95% CI 0.9–1.3], p Conclusion DLBCL represents a clinically and genetically heterogeneous group of lymphoma. Analysis of gene and protein levels of BCL2, C-MYC and BCL-6 alterations and clinical information provide important prognostic information to help identify a high-risk group of patients.