Abstract
We have previously shown that expression of CD40 has a favorable prognostic impact in diffuse large B-cell lymphoma (DLBCL) after anthracycline-based chemotherapy. Here we examined the prognostic value of immunohistochemically defined CD40 expression in 95 patients with DLBCL treated with both anthracycline-based chemotherapy and rituximab. Using a 10% cut-off level, 77% of the patients had CD40-positive tumors and showed a superior overall survival (p = 0.02 log-rank, hazard ratio 0.35, 95% CI 0.14-0.88, p = 0.03 Cox regression). When adjusted for International Prognostic Index in multivariate analysis, CD40 was not an independent prognostic factor (hazard ratio 0.39, 95% CI 0.15-1.04, p = 0.06 Cox regression). However, even after the introduction of immunochemotherapy, CD40 has a potential prognostic impact in DLBCL. Additional and larger studies are necessary, regarding the immunohistochemical robustness of CD40 and the biological mechanisms that contribute to the superior prognosis in CD40-expressing DLBCL.
MeSH terms
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Adult
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Aged
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Aged, 80 and over
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Antibodies, Monoclonal, Murine-Derived / administration & dosage
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Biomarkers, Tumor / metabolism*
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CD40 Antigens / metabolism*
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Cyclophosphamide / administration & dosage
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DNA-Binding Proteins / metabolism
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Doxorubicin / administration & dosage
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Female
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Humans
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Immunoenzyme Techniques
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Immunotherapy*
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Interferon Regulatory Factors / metabolism
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Lymphoma, Large B-Cell, Diffuse / drug therapy*
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Lymphoma, Large B-Cell, Diffuse / immunology
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Lymphoma, Large B-Cell, Diffuse / metabolism*
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Male
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Middle Aged
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Prednisone / administration & dosage
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Prognosis
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Proto-Oncogene Proteins c-bcl-2 / metabolism
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Proto-Oncogene Proteins c-bcl-6
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Rituximab
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Survival Rate
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Vincristine / administration & dosage
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Young Adult
Substances
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Antibodies, Monoclonal, Murine-Derived
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BCL6 protein, human
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Biomarkers, Tumor
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CD40 Antigens
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DNA-Binding Proteins
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Interferon Regulatory Factors
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Proto-Oncogene Proteins c-bcl-2
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Proto-Oncogene Proteins c-bcl-6
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interferon regulatory factor-4
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Rituximab
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Vincristine
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Doxorubicin
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Cyclophosphamide
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Prednisone