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PubMed · 14603341

Diffuse large B-cell lymphomas with plasmablastic/plasmacytoid features are associated with TP53 deletions and poor clinical outcome.

I Simonitsch-Klupp·I Hauser·G Ott·J Drach·J Ackermann·J Kaufmann·A Weltermann·H T Greinix·C Skrabs·C Dittrich·D Lutz·R Pötter·C Mannhalter·K Lechner·A Chott·U Jaeger
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Abstract

To define reproducible criteria for subgroups of diffuse large B-cell lymphomas (DLBCL), including lymphomas with plasmablastic/plasmacytoid features (PB/PC-Fs), we investigated 66 DLBCL; the samples were categorized as either centroblastic (CB), immunoblastic (IB) or PB/PC-F applying standardized morphologic criteria. Blinded specimens were reviewed by three independent pathologists. The final consensus classification included 44 CB (67%), seven IB (10%) and 15 PB/PC-F (23%). The interobserver agreement between two centers (Vienna, Würzburg) was 93.5%. Most PB/PC-F were CD20+, cIgM+, MUM-1+, CD138+/-, bcl-6-, corresponding to an activated B-cell phenotype. Immunoglobulin-V(H) gene mutation analysis was consistent with a germinal or postgerminal center-cell origin. By fluorescence in situ hybridization analysis, 11/13 (85%) PB/PC-F had a monoallelic TP53 deletion. The pretreatment characteristics of patients with PB/PC-F included a tendency for more B symptoms, extranodal disease and a higher IPI. Importantly, PB/PC-F were resistant to standard chemotherapy (complete remission rate 47%, relapse rate 71%) and even autologous stem-cell transplantation. The median overall survival (OS) (14 months, P<0.002) and disease-free survival (6 months, P=0.02) were significantly shorter compared to patients with CB and IB. The OS difference was pronounced within the low and low-intermediate IPI risk group (P<0.001). Our data indicate a strong association of plasmablastic/plasmacytoid morphology with TP53 deletions, poor response to chemotherapy and short survival.

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AdultAgedAged, 80 and overAntigens, NeoplasmAntineoplastic Combined Chemotherapy ProtocolsBiomarkersFemaleFollow-Up StudiesGenes, ImmunoglobulinGenes, p53Germinal CenterHerpesvirus 4, HumanHumansImmunophenotypingIn Situ Hybridization, FluorescenceLymphoma, B-CellLymphoma, Large B-Cell, DiffuseLymphoma, Large-Cell, ImmunoblasticMaleMiddle AgedPlasma CellsPrognosisRNA, ViralSequence DeletionSurvival RateTreatment OutcomeJournal ArticleResearch Support, Non-U.S. Gov't

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BibTeXRIS

I Simonitsch-Klupp, I Hauser, G Ott, J Drach, J Ackermann, J Kaufmann, A Weltermann, H T Greinix, C Skrabs, C Dittrich, D Lutz, R Pötter, C Mannhalter, K Lechner, A Chott, U Jaeger. 2004. Diffuse large B-cell lymphomas with plasmablastic/plasmacytoid features are associated with TP53 deletions and poor clinical outcome.. https://doi.org/10.1038/sj.leu.2403206

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