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Pediatric Transplants

Impact of germinal center and non-germinal center phenotypes on overall and failure-free survival after high-dose chemotherapy and auto-SCT in primary diffuse large B-cell lymphoma

Bone Marrow Transplantation volume 42, pages 93–98 (2008)Cite this article

Abstract

Non-germinal center (non-GC) phenotype is an adverse prognostic factor in chemotherapy (CT)-treated diffuse large B-cell lymphoma (DLBCL) patients. To determine how high-dose therapy (HDT) supported with auto-SCT as first line therapy influences GC-associated outcome in young high-risk DLBCL patients GC and non-GC phenotypes were determined immunohistochemically from 63 patients. Of these, 29 primary high-risk DLBCL patients were treated with auto-SCT, whereas 34 CT-treated patients served as a control group. Consistent with previous studies, non-GC phenotype was associated with adverse outcome in CT-treated high-risk patients. In contrast, immunohistochemical classification by cell of origin did not associate with survival after auto-SCT. When the impact of treatment on the predictive value of cell of origin was analyzed, the non-GC patients, who received HDT, had a better failure-free survival (FFS) and overall survival (OS) than the patients treated with CT alone. In multivariate analyses, both age-adjusted International Prognostic Index (aaIPI) and treatment were independent prognostic factors for FFS and OS. For the patients with GC phenotype, the influence of auto-SCT on survival was not significant. The data imply that auto-SCT can overcome the adverse prognostic impact of the non-GC phenotype in patients with high-risk DLBCL and warrant additional prospective studies.

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Acknowledgements

The study was supported by grants from Finnish Medical Foundation, Finnish Cancer Societies, Juselius Foundation, University of Helsinki, Helsinki University Central Hospital, the Swedish Cancer Society, the Lions Research Foundation and the Research Foundation of the Department of Oncology, Uppsala University Hospital.

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Authors and Affiliations

  1. Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland

    H Nyman & S Leppä

  2. Molecular Cancer Biology Program, Biomedicum Helsinki, University of Helsinki, Helsinki, Finland

    H Nyman & S Leppä

  3. Department of Medicine, Kuopio University Hospital, Kuopio, Finland

    E Jantunen

  4. Department of Hematology, Helsinki University Central Hospital, Helsinki, Finland

    E Juvonen & E Elonen

  5. Department of Clinical Pathology, Kuopio University Hospital, Kuopio, Finland

    J Böhm & V-M Kosma

  6. Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Kuopio, Finland

    V-M Kosma

  7. Department of Oncology, Uppsala University Hospital, Uppsala, Sweden

    G Enblad

  8. Department of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland

    M-L Karjalainen-Lindsberg

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Correspondence to S Leppä.

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Supplementary Information accompanies the paper on Bone Marrow Transplantation website (http://www.nature.com/bmt)

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Nyman, H., Jantunen, E., Juvonen, E. et al. Impact of germinal center and non-germinal center phenotypes on overall and failure-free survival after high-dose chemotherapy and auto-SCT in primary diffuse large B-cell lymphoma. Bone Marrow Transplant 42, 93–98 (2008). https://doi.org/10.1038/bmt.2008.92

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