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CC BY-NC-ND 4.0 · Avicenna J Med 2020; 10(04): 241-248
DOI: 10.4103/ajm.ajm_81_20
Original Article

High Ki67 proliferation index but not cell-of-origin subtypes is associated with shorter overall survival in diffuse large B-cell lymphoma

Feras Zaiem
Hematopathology department, Barbara Ann Karmanos Center and Wayne State University School of Medicine, Detroit, Michigan, USA
,
Rada Jerbi
Pathology Department, Christ Hospital, Cincinnati, Ohio, USA
,
Omar Albanyan
Division of Hematology/Oncology, Barbara Ann Karmanos Center and Wayne State University School of Medicine, Detroit, Michigan, USA
,
Jordyn Puccio
Hematopathology department, Barbara Ann Karmanos Center and Wayne State University School of Medicine, Detroit, Michigan, USA
,
Zyad Kafri
Division of Hematology and Oncology, St. John Hospital and Medical Center, Detroit, Michigan, USA
,
Jay Yang
Division of Hematology/Oncology, Barbara Ann Karmanos Center and Wayne State University School of Medicine, Detroit, Michigan, USA
,
Ali M Gabali
Hematopathology department, Barbara Ann Karmanos Center and Wayne State University School of Medicine, Detroit, Michigan, USA
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Abstract

Background: CD10, BCL6, and MUM1 are commonly used immunohistochemical stains for classifying diffuse large B-cell lymphoma (DLBCL), which is useful in predicting outcome. Conflicting reports of the prognostic value of other markers such as BCL2, CD23, and Ki67 proliferation index have been reported. Our objective was to correlate these immunostains and Hans classification with response to therapy and overall survival. Materials and Methods: A retrospective study of patients diagnosed with DLBCL from 2008–2014 at a tertiary-care cancer hospital. The slides with the IHC stains were reviewed by two independent pathologists. The clinical outcomes––assessed independently––were response to therapy and overall survival. The treatment response evaluation was based on the new Lugano classification. Statistical analyses were conducted using the Fisher’s exact test and Kaplan–Meier survival curves. Significance was set at P < 0.05. Results: Forty-one patients were included in the study with a known Hans classification, available clinical data, and at least 5-year follow-up. CD10 immunostain was reported in all patients, whereas CD23 was the least reported in only four patients. No significant association was observed between CD10, BCL6, MUM1, BCL2, and both Response to therapy and overall survival. Owing to few cases reported CD23 immunostain, further analysis of association is not reported. High Ki67 proliferative index of >80% was statistically significantly associated with shorter overall survival and not statistically significant associated with no response to therapy. Hans classification subtypes were not predictive in regard to therapy response. Conclusion: High Ki67 expression (>80%) was associated with shorter overall survival in DLBCL. Hans classification subtypes were not predictive.

Keywords

Activated B-cell (ABC) - BCL2 - BCL6 - B-lymphocytes - CD10 - CD23 - cell-of-origin classification - diffuse large B-cell lymphoma (DLBCL) - germinal center B-cell (GCB) - immunohistochemistry - Ki67 - MUM1 - overall survival - therapy response


Publication History

Article published online:
04 August 2021

© 2020. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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