Clinical significance of nuclear factor κB and chemokine receptor CXCR4 expression in patients with diffuse large B-cell lymphoma who received rituximab-based therapy

• Published in: The Korean journal of internal medicine 2014, 29(6), , pp.785-792
• Main Authors: Shin, Ho Cheol, Seo, Jongwon, Kang, Byung Woog, Moon, Joon Ho, Chae, Yee Soo, Lee, Soo Jung, Lee, Yoo Jin, Han, Seoae, Seo, Sang Kyung, Kim, Jong Gwang, Sohn, Sang Kyun, Park, Tae-In
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal, Murine-Derived - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomarkers, Tumor - analysis; Chi-Square Distribution; Cyclophosphamide - administration & dosage; Disease Progression; Disease-Free Survival; Doxorubicin - administration & dosage; Female; Humans; Immunohistochemistry; Kaplan-Meier Estimate; Lymphoma, Large B-Cell, Diffuse - chemistry; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - mortality; Lymphoma, Large B-Cell, Diffuse - pathology; Male; Middle Aged; Multivariate Analysis; Neoplasm Staging; NF-kappa B - analysis; Original; Predictive Value of Tests; Prednisone - administration & dosage; Proportional Hazards Models; Receptors, CXCR4 - analysis; Retrospective Studies; Risk Factors; Rituximab; Time Factors; Treatment Outcome; Vincristine - administration & dosage; Young Adult; 내과학
• ISSN: 1226-3303; 2005-6648
• DOI: 10.3904/kjim.2014.29.6.785

This study investigated the expression of nuclear factor κB (NF-κB) and the chemokine receptor (CXCR4) in patients with diffuse large B-cell lymphoma (DLBCL) who received rituximab-based therapy. Seventy patients with DLBCL and treated with rituximab-CHOP (R-CHOP) were included, and immunohistochemistry was performed to determine the expression of NF-κB (IκB kinase α, p50, and p100/p52) and CXCR4. To classify DLBCL cases as germinal center B-cell-like (GCB) and non-GCB, additional immunohistochemical expression of CD10, bcl-6, or MUM1 was used in this study. The expression was divided into two groups according to the intensity score (negative, 0 or 1+; positive, 2+ or 3+). The median age of the patients was 66 years (range, 17 to 87), and 58.6% were male. Twenty-seven patients (38.6%) had stage III or IV disease at diagnosis. Twenty-three patients (32.9%) were categorized as high or high-intermediate risk according to their International Prognostic Indexs (IPIs). The overall incidence of bone marrow involvement was 5.7%. Rates of positive NF-κB and CXCR4 expression were 84.2% and 88.6%, respectively. High NF-κB expression was associated with CXCR4 expression (p = 0.002), and 56 patients (80.0%) showed coexpression. However, the expression of NF-κB or CXCR4 was not associated with overall survival and EFS. On multivariate analysis that included age, gender, performance status, stage, and the IPI, no significant association between the grade of NF-κB or CXCR4 expression and survival was observed. The current study suggests that the tissue expression of NF-κB and CXCR4 may not be an independent prognostic marker in DLBCL patients treated with R-CHOP.