Clinical and biological significance of de novo CD5+ diffuse large B-cell lymphoma in Western countries.

Clinical and biological significance of de novo CD5+ diffuse large B-cell lymphoma in Western countries.
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DOI:
10.18632/oncotarget.3479
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发表时间:
2015-03-20
期刊:
影响因子:
--
通讯作者:
Young KH
Young KH
中科院分区:
其他
文献类型:
--
作者:
Xu-Monette ZY;Tu M;Jabbar KJ;Cao X;Tzankov A;Visco C;Nagarajan L;Cai Q;Montes-Moreno S;An Y;Dybkaer K;Chiu A;Orazi A;Zu Y;Bhagat G;Richards KL;Hsi ED;Choi WW;van Krieken JH;Huh J;Ponzoni M;Ferreri AJ;Zhao X;Møller MB;Farnen JP;Winter JN;Piris MA;Miranda RN;Medeiros LJ;Young KH

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CD5 是一种泛 T 细胞表面标志物,在弥漫性大 B 细胞淋巴瘤 (DLBCL) 中很少表达。西方国家缺乏针对新发 CD5+ DLBCL 的大规模研究。在 DLBCL Rituximab-CHOP Consortium 的这项研究中,来自西方国家的 879 名 DLBCL 患者中有 5.5% 表达 CD5。 CD5+ DLBCL 与 >1 ECOG 体能状态、骨髓受累、中枢神经系统复发、B 细胞样亚型激活、Bcl-2 过表达以及 STAT3 和 NF-κB 激活的频率较高相关,而很少表达单链 DNA 结合蛋白 2 (SSBP2)、CD30 或具有 MYC 突变。采用标准 R-CHOP 化疗后,CD5+ DLBCL 患者的总生存期(中位生存期为 25.3 个月 vs 未达到,P < .0001)和无进展生存期(中位生存期为 21.3 个月 vs 85.8 个月,P < .0001)显着低于 CD5− DLBCL 患者,且与 Bcl-2、STAT3、NF-κB 和国际预后指数无关。有趣的是,SSBP2 表达消除了 CD5 表达的预后意义,表明 SSBP2 对 CD5 信号传导具有肿瘤抑制作用。基因表达谱表明,B 细胞受体信号传导功能障碍和微环境改变是 CD5 表达临床影响的重要机制。这项研究显示了西方国家 CD5+ DLBCL 患者独特的临床和生物学特征,并强调了具有治疗意义的重要途径。
CD5 is a pan-T-cell surface marker and is rarely expressed in diffuse large B-cell lymphoma (DLBCL). Large-scale studies of de novo CD5+ DLBCL are lacking in Western countries. In this study by the DLBCL Rituximab-CHOP Consortium, CD5 was expressed in 5.5% of 879 DLBCL patients from Western countries. CD5+ DLBCL was associated with higher frequencies of >1 ECOG performance status, bone marrow involvement, central nervous system relapse, activated B-cell–like subtype, Bcl-2 overexpression, and STAT3 and NF-κB activation, whereas rarely expressed single-stranded DNA-binding protein 2 (SSBP2), CD30 or had MYC mutations. With standard R-CHOP chemotherapy, CD5+ DLBCL patients had significantly worse overall survival (median, 25.3 months vs. not reached, P< .0001) and progression-free survival (median, 21.3 vs. 85.8 months, P< .0001) than CD5− DLBCL patients, which was independent of Bcl-2, STAT3, NF-κB and the International Prognostic Index. Interestingly, SSBP2 expression abolished the prognostic significance of CD5 expression, suggesting a tumor-suppressor role of SSBP2 for CD5 signaling. Gene-expression profiling demonstrated that B-cell receptor signaling dysfunction and microenvironment alterations are the important mechanisms underlying the clinical impact of CD5 expression. This study shows the distinctive clinical and biological features of CD5+ DLBCL patients in Western countries and underscores important pathways with therapeutic implications.
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