Molecular and immunological dissection of diffuse large B cell lymphoma: CD5+, and CD5− with CD10+ groups may constitute clinically relevant subtypes

Abstract

Diffuse large B cell lymphoma (DLBL) constitutes the greatest percentage of adult non-Hodgkin's lymphomas and represents a diverse spectrum of lymphoid neoplasms. Clinicopathologic, phenotypic and genotypic findings were correlated and compared for 63 DLBL cases to investigate whether they represent clinically relevant subtypes. They were all cyclin D1 negative and were phenotypically divided into three groups, ie group I (CD5 + type, n = 11), group II (CD5 − CD10 + type, n = 19), and group III (CD5 − CD10 − type, n = 33). Data were correlated by observing the respective gene rearrangement and expression of BCL2 and BCL6. In clinical aspects, the group I cases demonstrated a significantly inferior survival than those of the other two groups (log-rank test, P = 0.016). Although rearrangement of BCL2 and BCL6 did not show any inclination to a specific subgroup, the immunohistochemical detection of BCL2 was less frequent, at a statistically significant level (P = 0.011), in group II (50%) than in group I (82%) and III (82%) cases. This appears to confirm the unique aspect of the CD5 − CD10 + type DLBL, indicating a certain relationship with the normal germinal center cells which usually lack BCL2 expression. The BCL6 protein expression was detected in most of the present DLBL cases (92%) irrespective of this grouping. These data suggest that the phenotypic delineation by the detection of CD5 and CD10 will improve our understanding of DLBL and be helpful in a future subgrouping of DLBL.

Expression of PKC-beta or cyclin D2 predicts for inferior survival in diffuse large B-cell lymphoma

“…Multiple studies have looked at the expression of bcl-2 using immunostains and most have found no difference in overall survival. 16,23,[27][28][29][30][31][32][33][34][35] However, some studies have found that bcl-2 expression is associated with a significantly worse overall survival, 3,[36][37][38][39][40][41][42] or event-free survival. [29][30][31]36,37 The discrepancies related to bcl-2 expression and prognosis may be related to the underlying subgroups of DLBCL.…”

Diffuse blastoid B-cell lymphoma: a histologically aggressive variant of t(14;18)-negative follicular lymphoma

“…The prognostic significance of T-cell antigen expression in B-cell non-Hodgkin's lymphomas remains somewhat controversial. CD5 expression in some series of extranodal marginal zone lymphoma 27,28 and de novo diffuse large B-cell lymphoma 22,23,29 has been associated with a clinically aggressive course and tendency for dissemination, although other studies have failed to support these findings. 30 Only one of five patients with clinical follow-up data in our study died of disease.…”

“…[18][19][20] Although CD5 expression is characteristic of chronic lymphocytic leukemia/small lymphocytic lymphoma and mantle cell lymphoma, it is rarely observed in other categories of B-cell non-Hodgkin's lymphoma. [21][22][23] CD43 expression, although relatively common in several subtypes of B-cell non-Hodgkin's lymphoma, is unusual in follicular lymphoma (3%). 24 However, CD43 expression is detected relatively often in cases of high-grade follicular lymphoma both with and without diffuse areas.…”

Comparison of Multiparameter Flow Cytometry with Cluster Analysis and Immunohistochemistry for the Detection of CD10 in Diffuse Large B-Cell Lymphomas

“…Similarly, Uherova et al (7) reported that CD10 expression in DLBCL correlated with shortened overall survival. In contrast, Harada et al (18) found no difference in overall survival between CD10(ϩ) and CD10(Ϫ) DLBCL patients. The availability of paraffin-reactive antibodies directed against CD10 suggests that retrospective studies with fixed tissue may be possible to confirm the prognostic significance of CD10 on DLBCL.…”

“…CD10 is expressed in a subset of DLBCL, a heterogeneous group of non-Hodgkin's lymphomas (6,7,17,18). The majority of DLBCL patients can be cured with current treatment regimens, whereas a minority fail to achieve complete remission and rapidly progress to death.…”