CD40 is a potential marker of favorable prognosis in patients with diffuse large B-cell lymphoma treated with immunochemotherapy

• Published in: Leukemia & lymphoma 2010-09, Vol.51 (9), p.1643-1648
• Main Authors: Rydström, Karin, Linderoth, Johan, Nyman, Heidi, Ehinger, Mats, Joost, Patrick, Bendahl, Pär-Ola, Leppä, Sirpa, Jerkeman, Mats
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal, Murine-Derived - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomarkers, Tumor - metabolism; Cancer and Oncology; Cancer och onkologi; CD40; CD40 Antigens - metabolism; Clinical Medicine; Cyclophosphamide - administration & dosage; diffuse large B-cell lymphoma; DNA-Binding Proteins - metabolism; Doxorubicin - administration & dosage; Female; Humans; Immunoenzyme Techniques; Immunotherapy; Interferon Regulatory Factors - metabolism; Klinisk medicin; Lymphoma; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - immunology; Lymphoma, Large B-Cell, Diffuse - metabolism; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Middle Aged; Prednisone - administration & dosage; Prognosis; prognostication; Proto-Oncogene Proteins c-bcl-2 - metabolism; Proto-Oncogene Proteins c-bcl-6; Rituximab; Survival Rate; Vincristine - administration & dosage; Young Adult
• ISSN: 1042-8194; 1029-2403; 1029-2403
• DOI: 10.3109/10428194.2010.492537

We have previously shown that expression of CD40 has a favorable prognostic impact in diffuse large B-cell lymphoma (DLBCL) after anthracycline-based chemotherapy. Here we examined the prognostic value of immunohistochemically defined CD40 expression in 95 patients with DLBCL treated with both anthracycline-based chemotherapy and rituximab. Using a 10% cut-off level, 77% of the patients had CD40-positive tumors and showed a superior overall survival (p = 0.02 log-rank, hazard ratio 0.35, 95% CI 0.14-0.88, p = 0.03 Cox regression). When adjusted for International Prognostic Index in multivariate analysis, CD40 was not an independent prognostic factor (hazard ratio 0.39, 95% CI 0.15-1.04, p = 0.06 Cox regression). However, even after the introduction of immunochemotherapy, CD40 has a potential prognostic impact in DLBCL. Additional and larger studies are necessary, regarding the immunohistochemical robustness of CD40 and the biological mechanisms that contribute to the superior prognosis in CD40-expressing DLBCL.