Annals of Oncology Advance Access published online on June 23, 2008
Annals of Oncology, doi:10.1093/annonc/mdn392
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CD5 expression is potentially predictive of poor outcome among biomarkers in patients with diffuse large B-cell lymphoma receiving rituximab plus CHOP therapy
1 Department of Medical Oncology and Hematology, Cancer Institute Hospital
2 Devision of Pathology, The Japanese Foundation for Cancer Research, Tokyo
3 Department of Epidemiology
4 Department of Transfusion Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama
5 Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu
6 Department of Hematopoietic Stem Cell Transplantation Data Management, Nagoya University School of Medicine, Nagoya
7 Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
* Correspondence to: Dr K. Hatake, Department of Medical Oncology and Hematology, Cancer Institute Hospital, 3-10-6 Ariake Koto-ku, Tokyo 135-8550, Japan. Tel: +81-3-3520-0111; Fax: +81-3-3570-0343; E-mail: khatake{at}jfcr.or.jp
Background: Several biomarkers indicating poor prognosis have been reassessed in patients receiving rituximab combination chemotherapy for diffuse large B-cell lymphoma (DLBCL). However, few studies have investigated outcome in relation to a combination of these biomarkers. In addition, no large-scale studies have reassessed the outcome of patients with CD5-positive DLBCL treated with rituximab.
Patients and methods: We conducted a retrospective study and investigated the predictive value of three biomarkers—BCL2, germinal center (GC) phenotype and CD5—in 121 DLBCL patients treated with rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone.
Results: CD5-positive patients showed significantly poorer event-free survival (EFS) and overall survival (OS) than CD5-negative patients (2-year EFS, 18% versus 73%, P < 0.001; 2-year OS, 45% versus 91%, P = 0.001). However, no significant difference in outcome according to BCL2 or GC phenotype was observed. Multivariate analysis revealed that CD5 expression was a significant prognostic factor for EFS [hazard ratio 14.2, 95% confidence interval (CI) 4.7–43.2] and OS (hazard ratio 20.3, 95% CI 3.6–114.4).
Conclusions: CD5 expression was the only significant prognostic factor among the biomarkers examined in this study. Further studies with larger numbers are warranted to confirm the prognostic significance of CD5 expression for patients with DLBCL receiving rituximab-containing chemotherapy.
biomarker, CD5, diffuse large B-cell lymphoma, rituximab
Received for publication May 3, 2008. Accepted for publication May 19, 2008.
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