Immunophenotypic Analysis of AIDS-Related Diffuse Large B-Cell Lymphoma and Clinical Implications in Patients from AIDS Malignancies Consortium Clinical Trials 010 and 034

Amy Chadburn, April Chiu, Jeannette Y. Lee, Xia Chen, Elizabeth Hyjek, Alison H. Banham, Ariela Noy, Lawrence D. Kaplan, Joseph A. Sparano, Kishor Bhatia, Ethel Cesarman

Research output: Contribution to journalArticle

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Abstract

Purpose: Diffuse large B-cell lymphoma (DLBCL) represents a clinically heterogeneous disease. Models based on immunohistochemistry predict clinical outcome. These include subdivision into germinal center (GC) versus non-GC subtypes; proliferation index (measured by expression of Ki-67), and expression of BCL-2, FOXP1, or B-lymphocyte-induced maturation protein (Blimp-1)/PRDM1. We sought to determine whether immunohistochemical analyses of biopsies from patients with DLBCL having HIV infection are similarly relevant for prognosis. Patients and Methods: We examined 81 DLBCLs from patients with AIDS in AMC010 (cyclophosphamide, doxorubicin, vincristine, and prednisone [CHOP] v CHOP-rituximab) and AMC034 (etoposide, doxorubicin, vincristine, prednisone, and dose-adjusted cyclophosphamide plus rituximab concurrent v sequential) clinical trials and compared the immunophenotype with survival data, Epstein-Barr virus (EBV) positivity, and CD4 counts. Results: The GC and non-GC subtypes of DLBCL did not differ significantly with respect to overall survival or CD4 count at cancer presentation. EBV could be found in both subtypes of DLBCL, although less frequently in the GC subtype, and did not affect survival. Expression of FOXP1, Blimp-1/ PRDM1, or BCL-2 was not correlated with the outcome in patients with AIDS-related DLBCL. Conclusion: These data indicate that with current treatment strategies for lymphoma and control of HIV infection, commonly used immunohistochemical markers may not be clinically relevant in HIV-infected patients with DLBCL. The only predictive immunohistochemical marker was found to be Ki-67, where a higher proliferation index was associated with better survival, suggesting a better response to therapy in patients whose tumors had higher proliferation rates.

Original languageEnglish (US)
Pages (from-to)5039-5048
Number of pages10
JournalJournal of Clinical Oncology
Volume27
Issue number30
DOIs
StatePublished - Oct 20 2009
Externally publishedYes

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Lymphoma, Large B-Cell, Diffuse
Acquired Immunodeficiency Syndrome
Clinical Trials
Germinal Center
Neoplasms
Survival
Vincristine
CD4 Lymphocyte Count
Prednisone
Human Herpesvirus 4
Doxorubicin
Cyclophosphamide
HIV Infections
Etoposide
Lymphoma
B-Lymphocytes
Immunohistochemistry
HIV
Biopsy
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Immunophenotypic Analysis of AIDS-Related Diffuse Large B-Cell Lymphoma and Clinical Implications in Patients from AIDS Malignancies Consortium Clinical Trials 010 and 034. / Chadburn, Amy; Chiu, April; Lee, Jeannette Y.; Chen, Xia; Hyjek, Elizabeth; Banham, Alison H.; Noy, Ariela; Kaplan, Lawrence D.; Sparano, Joseph A.; Bhatia, Kishor; Cesarman, Ethel.

In: Journal of Clinical Oncology, Vol. 27, No. 30, 20.10.2009, p. 5039-5048.

Research output: Contribution to journalArticle

Chadburn, Amy ; Chiu, April ; Lee, Jeannette Y. ; Chen, Xia ; Hyjek, Elizabeth ; Banham, Alison H. ; Noy, Ariela ; Kaplan, Lawrence D. ; Sparano, Joseph A. ; Bhatia, Kishor ; Cesarman, Ethel. / Immunophenotypic Analysis of AIDS-Related Diffuse Large B-Cell Lymphoma and Clinical Implications in Patients from AIDS Malignancies Consortium Clinical Trials 010 and 034. In: Journal of Clinical Oncology. 2009 ; Vol. 27, No. 30. pp. 5039-5048.
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abstract = "Purpose: Diffuse large B-cell lymphoma (DLBCL) represents a clinically heterogeneous disease. Models based on immunohistochemistry predict clinical outcome. These include subdivision into germinal center (GC) versus non-GC subtypes; proliferation index (measured by expression of Ki-67), and expression of BCL-2, FOXP1, or B-lymphocyte-induced maturation protein (Blimp-1)/PRDM1. We sought to determine whether immunohistochemical analyses of biopsies from patients with DLBCL having HIV infection are similarly relevant for prognosis. Patients and Methods: We examined 81 DLBCLs from patients with AIDS in AMC010 (cyclophosphamide, doxorubicin, vincristine, and prednisone [CHOP] v CHOP-rituximab) and AMC034 (etoposide, doxorubicin, vincristine, prednisone, and dose-adjusted cyclophosphamide plus rituximab concurrent v sequential) clinical trials and compared the immunophenotype with survival data, Epstein-Barr virus (EBV) positivity, and CD4 counts. Results: The GC and non-GC subtypes of DLBCL did not differ significantly with respect to overall survival or CD4 count at cancer presentation. EBV could be found in both subtypes of DLBCL, although less frequently in the GC subtype, and did not affect survival. Expression of FOXP1, Blimp-1/ PRDM1, or BCL-2 was not correlated with the outcome in patients with AIDS-related DLBCL. Conclusion: These data indicate that with current treatment strategies for lymphoma and control of HIV infection, commonly used immunohistochemical markers may not be clinically relevant in HIV-infected patients with DLBCL. The only predictive immunohistochemical marker was found to be Ki-67, where a higher proliferation index was associated with better survival, suggesting a better response to therapy in patients whose tumors had higher proliferation rates.",
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AU - Chadburn, Amy

AU - Chiu, April

AU - Lee, Jeannette Y.

AU - Chen, Xia

AU - Hyjek, Elizabeth

AU - Banham, Alison H.

AU - Noy, Ariela

AU - Kaplan, Lawrence D.

AU - Sparano, Joseph A.

AU - Bhatia, Kishor

AU - Cesarman, Ethel

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