| Literature DB >> 26248897 |
Zhiyu Liu1, Zijun Y Xu-Monette1, Xin Cao1, Ganiraju C Manyam2, Xiaoxiao Wang1, Alexandar Tzankov3, Yi Xia1, Xin Li1, Carlo Visco4, Ruifang Sun1, Li Zhang2, Santiago Montes-Moreno5, Karen Dybkær6, April Chiu7, Attilio Orazi8, Youli Zu9, Govind Bhagat10, Kristy L Richards11, Eric D Hsi12, William W L Choi13, J Han van Krieken14, Jooryung Huh15, Maurilio Ponzoni16, Andrés J M Ferreri16, Ben M Parsons17, Michael B Møller18, Miguel A Piris5, Jane N Winter19, Dennis P O'Malley20, L Jeffrey Medeiros1, Ken H Young1,21.
Abstract
Survivin, a member of the inhibitor of apoptosis protein family, is overexpressed in a variety of human neoplasms. The prognostic significance of survivin expression in diffuse large B-cell lymphoma patients treated with rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) is unclear. We used standard immunohistochemistry methods to quantify survivin expression in 463 patients with de novo diffuse large B-cell lymphoma who received the R-CHOP. Of the 463 patients, 269 (58%) had survivin overexpression with a cutoff of >25%, associated with an International Prognostic Index score of >2 (P=0.015), disease in ≥2 extranodal sites (P=0.011), and a high Ki-67 index (P<0.0001). Among patients with activated B cell-like disease, the overall survival rate of survivin-positive patients was significantly lower than that of survivin-negative patients (P=0.033); multivariate analysis confirmed that in these patients, survivin overexpression was an independent prognostic factor for survival. Among patients with wild-type p53 overexpression, the overall survival and progression-free survival rates of the survivin-positive group were significantly lower than those of the survivin-negative group (P=0.035 and P=0.04 respectively). In STAT3-positive patients, survivin overexpression was associated with significantly better survival. Among patients with activated B cell-like disease, survivin-positive compared with survivin-negative groups had significantly different gene expression signatures, including genes involved in mitosis or tumor cell proliferation. Our results indicate that survivin is an independent prognostic factor for poor outcome in patients with activated B cell-like disease treated with the R-CHOP regimen, and patients with survivin-positive activated B cell-like diffuse large B-cell lymphoma seem to benefit less from this treatment and may require additional novel agents.Entities:
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Year: 2015 PMID： 26248897 DOI： 10.1038/modpathol.2015.94
Source DB: PubMed Journal: Mod Pathol ISSN： 0893-3952 Impact factor: 7.842