Bcl-2 protein expression is the strongest independent prognostic factor of survival in primary cutaneous large B-cell lymphomas

被引:87
作者
Grange, F
Petrella, T
Beylot-Barry, M
Joly, P
D'Incan, M
Delaunay, M
Machet, L
Avril, MF
Dalac, S
Bernard, P
Carlotti, A
Esteve, E
Vergier, B
Dechelotte, P
Cassagnau, E
Courville, P
Saiag, P
Laroche, L
Bagot, M
Wechsler, J
机构
[1] Hop Louis Pasteur, Dept Dermatol, F-68024 Colmar, France
[2] Hop Bocage, Ctr Pathol, Dijon, France
[3] Hop Bocage, Dept Pathol, Dijon, France
[4] Hop Henri Mondor, Dept Dermatol, F-94010 Creteil, France
[5] Hop Laut Leveque, Dept Dermatol, Pessac, France
[6] Hop Charles Nicolle, Dept Dermatol, Rouen, France
[7] Hop Hotel Dieu, Dept Dermatol, Clermont Ferrand, France
[8] Hop Pellegrin, Dept Dermatol & Cancerol, F-33076 Bordeaux, France
[9] Hop Trousseau, Dept Dermatol, Tours, France
[10] Inst Gustave Roussy, Dept Dermatol, Villejuif, France
[11] Hop Bocage, Dept Dermatol, Dijon, France
[12] Hop Robert Debre, Dept Dermatol, Reims, France
[13] Hop Tamier, Dept Pathol, Paris, France
[14] Hop Porte Madeleine, Dept Dermatol, Orleans, France
[15] Hop Haut Leveque, Dept Pathol, Pessac, France
[16] Hop Hotel Dieu, Dept Pathol, Clermont Ferrand, France
[17] Hop Hotel Dieu, Dept Pathol, Nantes, France
[18] Hop Charles Nicolle, Dept Pathol, Rouen, France
[19] Hop Ambroise Pare, Dept Dermatol, Boulogne, France
[20] Hop Avicenne, Dept Dermatol, F-93009 Bobigny, France
[21] Hop Henri Mondor, Dept Pathol, F-94010 Creteil, France
关键词
D O I
10.1182/blood-2003-08-2726
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Bcl-2 protein expression has been associated with poor prognosis in patients with noncutaneous diffuse large B-cell lymphomas. In primary cutaneous large B-cell lymphomas, the location on the leg, the round-cell morphology defined as the predominance of centroblasts and immunoblasts over large centrocytes, and multiple skin lesions were identified as adverse prognostic factors. The prognostic value of bcl-2 protein expression has not been studied in large series of patients. We evaluated 80 primary cutaneous large B-cell lymphomas collected by the French Study Group on Cutaneous Lymphomas. The prognostic value of age, sex, number of lesions, cutaneous extent, location, serum lactate dehydrogenase (LDH) level, B symptoms, morphology, and bcl-2 protein expression was studied. The overall 5-year specific survival rate was 65%. In univariate analysis, advanced age, multiple skin lesions (n = 48), location on the leg (n = 25), round-cell morphology (n = 32), and bcl-2 expression (n = 39) were significantly related to death from lymphoma. In multivariate analysis, bcl-2 expression (P =.0003), multiple skin lesions (P =.004), and age remained independent prognostic factors. The 5-year specific survival rates in bcl-2-positive and bcl-2-negative patients were 41% and 89%, respectively (P < .0001). A new prognostic classification of primary cutaneous B-cell lymphoma should be based primarily on bcl-2 protein expression rather than the location of skin lesions. (C) 2004 by The American Society of Hematology.
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收藏
页码:3662 / 3668
页数:7
相关论文
共 50 条
[1]   Germinal center phenotype and bcl-2 expression combined with the International Prognostic Index improves patient risk stratification in diffuse large B-cell lymphoma [J].
Barrans, SL ;
Carter, I ;
Owen, RG ;
Davies, FE ;
Patmore, RD ;
Haynes, AP ;
Morgan, GJ ;
Jack, AS .
BLOOD, 2002, 99 (04) :1136-1143
[2]  
Bekkenk MW, 2000, CANCER-AM CANCER SOC, V89, P913, DOI 10.1002/1097-0142(20000815)89:4<913::AID-CNCR26>3.0.CO
[3]  
2-8
[4]   Treatment of multifocal primary cutaneous B-cell lymphoma: A clinical follow-up study of 29 patients [J].
Bekkenk, MW ;
Vermeer, MH ;
Geerts, ML ;
Noordijk, EM ;
Heule, F ;
Vader, PCV ;
van Vloten, WA ;
Meijer, CJLM ;
Willemze, R .
JOURNAL OF CLINICAL ONCOLOGY, 1999, 17 (08) :2471-2478
[5]   Primary cutaneous large-cell lymphoma: analysis of 49 patients included in the LNH87 prospective trial of polychemotherapy for high-grade lymphomas [J].
Brice, P ;
Cazals, D ;
Mounier, N ;
Verola, O ;
Neidhart-Berard, AM ;
Remenieras, L ;
Deconinck, E ;
Doyen, C ;
Hamelsand, J ;
Molina, T ;
Moulonguet, I ;
Gisselbrecht, C .
LEUKEMIA, 1998, 12 (02) :213-219
[6]  
CAMPOS L, 1993, BLOOD, V81, P3091
[7]   CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. [J].
Coiffier, B ;
Lepage, E ;
Brière, J ;
Herbrecht, R ;
Tilly, H ;
Bouabdallah, R ;
Morel, P ;
Van den Neste, E ;
Salles, G ;
Gaulard, P ;
Reyes, F ;
Gisselbrecht, C .
NEW ENGLAND JOURNAL OF MEDICINE, 2002, 346 (04) :235-242
[8]  
COIFFIER B, 1989, BLOOD, V74, P558
[9]  
Connors Joseph M, 2002, Hematology Am Soc Hematol Educ Program, P263
[10]  
COX DR, 1972, J R STAT SOC B, V34, P187