DLBCL, GC and activation markers

Gene expression profiles similar to those of germinal centre B-cells are associated with a better prognosis in DLBCL, compared to those with B-cell activation profiles². This finding has been confirmed and shown to be an independent prognostic indicator, along with the International Prognostic Index³.

In diagnostic practice, immunohistochemistry is more readily available than cDNA profiling. Those whose DLBCL shows positivity for germinal centre markers (CD10 or bcl-6) AND are negative negative for activation markers (CD138 and MUM1/IRF4 (multiple myeloma-1/interferon regulatory factor-4) expression is developed by B-cells at a final stage as they leave the germinal centre and is retained thereafter.) have a much better prognosis (relative risk of death 0.135, p = 0.008)¹. By multivariate analysis, this immunohistochemical profile and the International Prognostic Index were significant independent predictors of survival.

References

¹Chang, C. C., S. McClintock, et al. (2004). "Immunohistochemical expression patterns of germinal center and activation B-cell markers correlate with prognosis in diffuse large B-cell lymphoma." Am J Surg Pathol 28(4): 464-70.

²Alizadeh, A. A., M. B. Eisen, et al. (2000). "Distinct types of diffuse large B-cell lymphoma identified by gene expression profiling." Nature 403(6769): 503-11.

³Rosenwald, A., G. Wright, et al. (2002). "The use of molecular profiling to predict survival after chemotherapy for diffuse large-B-cell lymphoma." N Engl J Med 346(25): 1937-47.