Prognostic value of CD10, BCL6 and MUM1 in diffuse large B-cell lymphoma

Abstract

Background: Diffuse large B-cell lymphoma (DLBCL) is considered the commonest subtype of non-Hodgkin lymphoma (NHL) in the world. It is a refractory disease with a high mortality rate due to frequent relapses. Several prognostic parameters are now widely studied for risk stratification and achieving a better outcome. Objectives: In this study, we aim to assess the prognostic value of immunohistochemical expression of CD10, BCL6, and MUM1 independently as surrogate markers for cell of origin (COO) classification of DLBCL and their correlation with clinicopathological characters and survival. Patients and methods: This is a retrospective study conducted on 63 cases of DLBCL, NOS. Full-faced sections were constructed and immunostained for CD10, BCL6, and MUM1. Results: CD10 expression was associated with early-stage (P=0.003), normal serum LDH level (P=0.022), absence of B symptoms (P=0.019), low international prognostic index (IPI) and age-adjusted-IPI (P=0.001) and also associated with longer progression free survival (PFS) (P=0.006). BCL6 expression was associated with centroblastic variant (P=0.005), good ECOG performance status (P=0.038) and low IPI (P=0.004) and also associated with better overall survival (OS) (P=0.028) and PFS (P=0.018). MUM1 expression was associated with advanced-stage (P=0.002) while no significant association was detected with other clinicopathological parameters or survival. Conclusion CD10, BCL6, and MUM1 can be used independently as prognostic immunohistochemical markers for DLBCL that may denote the clinical behavior of the disease and further patients' outcomes.

High density of FOXP3 predicts better prognosis in germinal and non‐germinal centre diffuse large B‐cell lymphoma

“…The cases were classified as positive for each marker when ≥30% of tumour cells are stained with this marker. Then, the cases were reclassified into GCB or non‐GCB according to the following Hans classifier: GCB (CD10+, BCL6+/−, MUM1−/+ or CD10‐, BCL6+, MUM1‐) and non‐GCB (CD10‐, BCL6‐, MUM1+/− or CD10‐, BCL6+, MUM1+) 14,15 …”

“…Then, the cases were reclassified into GCB or non-GCB according to the following Hans classifier: GCB (CD10+, BCL6+/−, MUM1−/+ or CD10-, BCL6+, MUM1-) and non-GCB (CD10-, BCL6-, MUM1+/− or CD10-, BCL6+, MUM1+). 14,15 Both Tregs and macrophages were calculated in tissue sections by counting the number of FOXP3+ Tregs and CD68 + macrophages in five regions of interest (ROIs). ROIs are defined as the highest areas within the section showing positive cells.…”