Abstract
Diffuse large B cell lymphoma (DLBCL) is a heterogeneous disease that displays a highly variable clinical outcome. It is a neoplasm of large transformed B cells with a diffuse growth pattern. DLBCL is the most common type of non-Hodgkin’s lymphoma (NHL) (31% of all cases). Approximately half of patients with DLBCL are cured with current chemotherapy regimens. The purpose of this study was to evaluate BCl2 expression in 45 patients diagnosed with DLBCL of head and neck region and correlate the level of its immunohistochemical expression with different clinicopathological variables with emphasis upon patients’ age, gender, nodal or extra-nodal location of lymphoma, patients’ response to chemotherapy, progression-free survival (PFS) and overall survival (OS). A retrospective analysis of 45 patients diagnosed to have DLBCL. A cut off value of ≥ 50% protein expression denoted BCL2 positivity. Out of 45 cases, 36 cases (80%) revealed BCL2 positive expression and 9 cases (20%) were BCL2 negative. We found statistically significant differences in BCL2 expression regarding different patients’ responses to chemotherapy, patients’ OS and PFS (p ≤ 0.05). No statistically significant differences in BCL2 expression regarding the patients’ Ann Arbor clinical stage, age group and tumor site (nodal or extra-nodal, p > 0.05) using the Chi-square test. BCL2 expression was analyzed in relation to 5 years OS and PFS using Kaplan Meier curves and Log Rank test for survival analysis. Cases that demonstrated BCL2 positivity revealed shortened OS and PFS with highly statistically significant differences among the studied variables (p = 0.000). We also found that patients who respond well to the chemotherapeutic regimen had negative BCL2 expression, the differences were statistically significant (p = 0.015). In conclusion, BCL2 expression could be considered a predictor for patients’ chemotherapeutic response, OS and PFS.
Highlights
The head and neck region is one of the most common sites for the extra-nodal lymphomas
The purpose of this study was to evaluate BCl2 expression in 45 patients diagnosed with Diffuse large B cell lymphoma (DLBCL) of head and neck region and correlate the level of its immunohistochemical expression with different clinicopathological variables with emphasis upon patients’ age, gender, nodal or extra-nodal location of lymphoma, patients’ response to chemotherapy, progression-free survival (PFS) and overall survival (OS)
We found that patients who respond well to the chemotherapeutic regimen had negative BCL2 expression, the differences were statistically signifi
Summary
The head and neck region is one of the most common sites for the extra-nodal lymphomas. DLBCL is a heterogeneous disease that shows various outcomes [3]. DLBCL is a common histological type of NHL (31% of all cases) [4]. The remaining 50% are chemoresistant and this regimen is not able to cure them [7]. The latter group usually recurs after CHOP-induced remission with a short disease-free interval [8]. Other strategies in treatment as a combination between chemotherapeutics and mononuclear antibodies, or intensive chemotherapeutics associated with transplantation of bone marrow may be effective to them [9] It would be extremely beneficial if we could detect previously which patients need more intensive treatments. Researchers have been trying to find prognostic factors that help in predicting who will experience good or unsatisfactory response
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