TY - JOUR
T1 - Evaluating cell-of-origin subtype methods for predicting diffuse large B-Cell lymphoma survival
T2 - A meta-analysis of gene expression profiling and immunohistochemistry algorithms
AU - Read, Jay A.
AU - Koff, Jean L.
AU - Nastoupil, Loretta J.
AU - Williams, Jessica N.
AU - Cohen, Jonathon B.
AU - Flowers, Christopher R.
N1 - Publisher Copyright:
© 2014 Elsevier Inc. All rights reserved.
PY - 2014
Y1 - 2014
N2 - 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 .
AB - 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 .
KW - Chemoimmunotherapy
KW - Non-Hodgkin lymphoma
KW - Prognosis
KW - Rituximab
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=84922631182&partnerID=8YFLogxK
U2 - 10.1016/j.clml.2014.05.002
DO - 10.1016/j.clml.2014.05.002
M3 - Article
C2 - 25052052
AN - SCOPUS:84922631182
SN - 2152-2650
VL - 14
SP - 460-467.e2
JO - Clinical Lymphoma, Myeloma and Leukemia
JF - Clinical Lymphoma, Myeloma and Leukemia
IS - 6
ER -