Cell of origin predicts outcome to treatment with etoposide-containing chemotherapy in young patients with high-risk diffuse large B-cell lymphoma.

Abstract	Addition of etoposide to the R-CHOP chemotherapy regimen with cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab (R-CHOEP) has resulted in improved survival in young patients with high-risk diffuse large B-cell lymphoma (DLBCL). It is not known whether biological factors can predict this effect. In this study, 245 patients representing all young patients with high-risk DLBCL treated with R-CHOP or R-CHOEP in 2004-2012 in Denmark were extracted from the Danish lymphoma database. Patients were stratified according to cell of origin (COO) into germinal-center B-cell-like (GCB) or non-GCB by Hans' algorithm. Only in patients with the GCB phenotype was treatment with R-CHOEP associated with improved progression-free survival (PFS) and overall survival (OS) compared with R-CHOP. Patients with GCB phenotype treated with R-CHOEP also had superior OS compared with patients with non-GCB phenotype treated with R-CHOEP. This was not seen in R-CHOP treated patients. This could suggest that R-CHOEP should be restricted to patients with GCB phenotype.
Authors	Anne O Gang, Mette Ø Pedersen, Helle Knudsen, Anne F Lauritzen, Michael Pedersen, Signe L Nielsen, Peter Brown, Estrid Høgdall, Tobias W Klausen, Peter Nørgaard
Journal	Leukemia & lymphoma (Leuk Lymphoma) Vol. 56 Issue 7 Pg. 2039-46 (Jul 2015) ISSN: 1029-2403 [Electronic] United States
PMID	25379621 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References	Rituximab Vincristine Etoposide Doxorubicin Cyclophosphamide Prednisone
Topics	Adult Antineoplastic Combined Chemotherapy Protocols (therapeutic use) B-Lymphocytes (pathology) Cell Lineage Cyclophosphamide (administration & dosage) Doxorubicin (administration & dosage) Etoposide (administration & dosage) Female Follow-Up Studies Germinal Center (pathology) Humans Lymphoma, Large B-Cell, Diffuse (drug therapy, mortality, pathology) Male Middle Aged Neoplasm Staging Prednisone (administration & dosage) Prognosis Retrospective Studies Risk Factors Rituximab (administration & dosage) Survival Rate Vincristine (administration & dosage)

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