Abstract
9639 Background: Although Diffuse Large B-cell Lymphomas (DLBCL) is usually considered as a specific disease entity, findings suggest diversity rather than a single clinicopathological entity. Clinical prognostic systems, including the International Prognostic Index (IPI), is useful in assessing overall prognosis with some reserve. It is likely that the prognostic assessment of patients with DLBCL might be improved by using biological features. Methods: To determine the clinical significance and prognostic value of biological markers expressed in DLBCL, we retrospectively studied 26 patients diagnosed as de novo DLBCL at Chungnam National University Hospital.Immunohistochemical studies were performed with CD10, bcl-6, IRF-4, bcl-2, p16, Granzyme B, and MHC-II, Ki-67 antibodies on archival pathology specimens. Two immunophenotypic patterns were distinguished according to the pattern of differentiation: germinal center (GC; CD10±/Bcl-6+/IRF-4 −) or post–germinal center (pGC; CD10±/bcl-6±/ IRF4+)type. Results: The median age was 56 (range;37∼69). 17 patients(65.4%) were male. 5 patients(19.2%) had ‘B’ symptoms. 11 patients(42.3%) had the elevated LDH level. 5 patients (19.2%) had bulky disease. After a median follow up duration of 48 months, the median survival time was 44 months with a range of 1∼100+ months. 5-year overall survival rate was 32% by Kaplan-Meier method. The clinical factors affecting survival were serum LDH level, stage, B Symptom, bulky disease, stage at diagnosis. The only immunologic marker affecting survival was bcl-2. In patients with the same IPI scores, bcl-2 positive patients had lower survival.(p = 0.002 ) The germinal center like type had better survival than post-germinal center like type but had no statistical significance. .(p = 0.064 ) Conclusion: Immunohistochemical profiles of DLBCL maybe useful in predicting survival, especially bcl-2 expression. Germinal center type had better survival than post-Germinal center like type without statistical significance. Large scale study in more patients are warranted. No significant financial relationships to disclose.
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