Prediktivni značaj biomarkera bcl2, bcl6, CD10 i MUM1 kod difuznih B krupnoćelijskih limfoma

Abstract

INTRODUCTION: Patients with diffuse large B-cell lymphoma (DLBCL) have heterogenous clinical course and prognosis. There is a continuing need for the development of contemporary predictive models for the stratification of patients. Immunohistochemical biomarkers in correlation with clinical and biochemical parametres can offer such predictive models for patient stratification. AIM: The main objective of this study was to examine the predictive value of immnohistochemical biomarkers expression (bcl2, bcl6, CD10 and MUM1), according to Hans and Muris algorithm and subclassification of Hans algorithm) with biochemical, clinical and score/index characteristics in the studied patient population in order to define their impact on the response to therapy, the risk of death and duration of progression free survival (PFS). METHODS: The techinique of classical semiquantitative immunohistochemical analysis for the biomarkers expression were used. All analyzed data were collected from medical documentation The statistical methods included the use of non-parametric tests (x2-test, Mann-Whitney U test, Kruskal-Wallis tests and others) as well the use of parametric tests if the characteristics were numeric and distribution normal (Student’s t-test, ANOVA). PFS was examined by Kaplan-Meier analysis. The univariate, and multivariate analysis of risk factors for response to therapy and duration of PFS were assessed. IMPORTANCE: The original contributions of this study are reflected in the confirmation of Muris’s score, as well as bcl2 biomarker and IPI score as parametres that have predictive value in the risk stratification of patients into prognostic categories in the rituximab era. This findings can be applied in real clinical practice. For the first time a correlation of NCCN-IPI score and bcl6 biomarker has been established in the prediction of therapeutic response. It was found that male gender was associated with an increased mortality risk in DLBCL patients.