Ekspresija molekulskih markera kao faktorprognoze lečenja difuznog B-krupnoćelijskog limfomaimunohemioterapijom

Abstract

Diffuse B - large cell lymphoma (DLBCL) is the most common subtype of non - Hodgkin's lymphoma in Europe and North America. The outcome of treatment of this disease depends on the number of risk factors included in the International Prognostic Score Index (IPI). However, neither IPI nor later designed, revised IPI (R- IPI ) can not fully predict which patient will respond well to the therapy and which patient will experience relapse after initial response to the treatment. Therefore, the era of the molecular markers hat will be able to give better answer to this issues, has started. In this study we examined the response to treatment, duration of progression -free survival and overall survival compared to the immunohistochemical expression of a molecules: Ki67, CD10, the MUM - 1, Bcl - 2, Bcl - 6, CD20, CD5, CD30, CD43, COX2, EBV-LMPI, VEGF - A, BAFF - R, BCMA, TACI. In addition, we investigated the impact of demographic, I clinical and laboratory parameters such are sex, age, clinical stage, presence of B symptoms, extra nodal localization, IPI score, albumin level, hemoglobin level and the absolute lymphocyte count on the treatment outcome. This study included 140 patients treated at the Oncology Institute of Vojvodina in the period from 'ear 2003 to 2010. All patients were treated with the combination of rituximab and CHOP (cyclophosphamide, doxorubicin, vinksristin, rednisone) or CHOP-like protocol. Complete ~emission was reached in 74.14 percents of patients. IPI score was the only parameter that affected the rates of complete remission. Three-year progression-free survival was achieved in 56.5 percents of patients, while hree-year overall survival was 64 percents. Patients with a high IPI score, low lymphocyte count, low albumin level and male patients have a shorter time to rogression. Also, patients who did not express BCMA eceptor have a shorter time to progression. Patients with high IPI score, low lymphocyte count, low albumin level and the expression of CD5 receptor had shorter progression free survival. On the other hand, patients expressing BCMA and BAFF - R have a significantly longer survival time. The other parameters did not affect the outcome of treatment. Besides the standard parameters, the expression of various molecule markers can contribute significantly to the prediction of treatment outcome of patients with DLBCL.