Prognostic implications of BCL6 rearrangement in uniformly treated patients with diffuse large B-cell lymphoma--a Nordic Lymphoma Group study

Int J Oncol. 2002 Jan;20(1):161-5. doi: 10.3892/ijo.20.1.161.

Abstract

The purpose of this study was to investigate the prognostic implications of BCL6 rearrangement in a uniformly treated population of patients with diffuse large B-cell lymphoma (DLBCL) and to characterise the relationship between BCL6 rearrangement and prognostic factors. A total of 269 patients with DLBCL entered a randomised trial comparing the chemotherapy regimen CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) to the MACOP-B (methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, bleomycin) regimen. In 44 cases, frozen tissue was available for assessment of BCL6 status by Southern blot analysis. BCL6 was rearranged in six of 43 evaluable cases (14%), and was associated with elevated lactate dehydrogenase (LDH), and a higher patient age. No association between BCL6 status and expression of BCL2, Ki-67 or TP53 was found. Patients presenting with BCL6 rearrangement displayed a weak trend towards better overall and failure-free survival (67 and 67% at 5 years), compared to patients with germline BCL6 (63 and 52%), but the difference was not statistically significant. In accordance with previously published series, the presence of BCL6 rearrangement does not define a prognostically distinct subgroup of DLBCL. Assessment of BCL6 status may, however, be of clinical interest when related to other prognostic variables.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bleomycin / therapeutic use
  • Blotting, Southern
  • Cyclophosphamide / therapeutic use
  • DNA, Neoplasm / analysis
  • DNA, Neoplasm / metabolism
  • DNA-Binding Proteins / genetics*
  • Doxorubicin / therapeutic use
  • Gene Rearrangement, B-Lymphocyte / genetics*
  • Humans
  • Immunophenotyping
  • L-Lactate Dehydrogenase / metabolism
  • Leucovorin / therapeutic use
  • Lymphoma, B-Cell / drug therapy
  • Lymphoma, B-Cell / genetics*
  • Lymphoma, Large B-Cell, Diffuse / drug therapy
  • Lymphoma, Large B-Cell, Diffuse / genetics*
  • Male
  • Methotrexate / therapeutic use
  • Middle Aged
  • Neoplasm Staging
  • Prednisone / therapeutic use
  • Prognosis
  • Proto-Oncogene Proteins / genetics*
  • Proto-Oncogene Proteins c-bcl-6
  • Transcription Factors / genetics*
  • Vincristine / therapeutic use

Substances

  • DNA, Neoplasm
  • DNA-Binding Proteins
  • Proto-Oncogene Proteins
  • Proto-Oncogene Proteins c-bcl-6
  • Transcription Factors
  • Bleomycin
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • L-Lactate Dehydrogenase
  • Leucovorin
  • Prednisone
  • Methotrexate

Supplementary concepts

  • CHOP protocol
  • MACOP-B protocol