Evaluating cell-of-origin subtype methods for predicting diffuse large B-Cell lymphoma survival: A meta-analysis of gene expression profiling and immunohistochemistry algorithms

Jay A. Read, Jean L. Koff, Loretta J. Nastoupil, Jessica N. Williams, Jonathon B. Cohen, Christopher R. Flowers

Research output: Contribution to journalArticlepeer-review

81 Scopus citations

Abstract

Meta-analyses comparing survival outcomes for diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab and anthracycline-based chemotherapy were performed to assess the prognostic significance of gene expression profiling (GEP) and immunohistochemistry (IHC). Gene expression profiling remains the preferred method for predicting DLBCL outcomes, and pooled results did not support the use of the Hans and Choi algorithms to predict overall survival.Background: Patients with DLBCL exhibit widely divergent outcomes despite harboring histologically identical tumors. Currently, GEP and IHC algorithms assign patients to 1 of 2 main subtypes: germinal center B cell-like (GCB), or activated B cell-like (ABC), the latter of which historically carries a less favorable prognosis. However, it remains controversial as to whether these prognostic groupings remain valid in the era of rituximab therapy .Materials and Methods: A systematic literature review identified 24 articles from which meta-analyses were conducted, comparing survival outcomes for patients assigned to either GCB or ABC/non-GCB subtype using GEP and/or Hans, Choi, or Muris IHC algorithms .Results: Patients designated as GCB DLBCL using GEP fared significantly better in terms of overall survival than those with ABC DLBCL (hazard ratio, 1.85; P < .0001). In contrast, the Hans and Choi algorithms failed to identify significant differences in overall survival (P = .07 and P = .76, respectively) between GCB and non-GCB groups .Conclusions: Our study illustrates a lack of evidence supporting the use of the Hans and Choi algorithms for stratifying patients into distinct prognostic groups. Rather, GEP remains the preferred method for predicting the course of a patient's disease and informing decisions regarding treatment options .

Original languageEnglish
Pages (from-to)460-467.e2
JournalClinical Lymphoma, Myeloma and Leukemia
Volume14
Issue number6
DOIs
StatePublished - 2014

Keywords

  • Chemoimmunotherapy
  • Non-Hodgkin lymphoma
  • Prognosis
  • Rituximab
  • Systematic review

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