The Expression of CD30 Based on Immunohistochemistry Predicts Inferior Outcome in Patients with Diffuse Large B-Cell Lymphoma

<div><p>The prognostic value of CD30 expression indiffuse large B-cell lymphoma (DLBCL)remains controversial. Herein, we performed this retrospective study to investigate the clinical and prognostic significance of CD30 expression in patients with DLBCL.Among all the 146 patients, the expression of CD30 was observed in 23 cases (15.7%).The DLBCL patients with CD30 expression showed more likely to present B symptoms, bone marrow involvement, non-germinal centre B-cell-like (Non-GCB) DLBCL, BCL-2 and Ki-67overexpression(p<0.05). Patients with CD30 expression showed significantly poor overall and event-free survivalcompared with CD30 negative patients(p = 0.031 and 0.041, respectively), especially those with the high intermediate/high-risk international prognostic index (IPI)(p = 0.001 and 0.007, respectively). The prognostic value of CD30expression retained in DLBCL patients treated with eitherCHOP (cyclophosphamide, doxorubicin, vincristine,prednisone) or R-CHOP(rituximab+CHOP). The multivariate analysisrevealed that the expression of CD30 remained an unfavorable factor for both overall and event-free survival (p = 0.001 and 0.002, respectively).In conclusion, these data suggest that CD30 is expressed predominantly in Non-GCBDLBCL. The expression of CD30 implied poor outcomein DLBCL patientstreated with either CHOP or R-CHOP, especially those with the high intermediate/high-risk IPI, possibly indicating that anti-CD30 monoclonal antibody could be of clinical interest.</p></div

Multivariate Cox regression analysis for survival.

<p>LDH, Lactate dehydrogenase; IPI,internationalprognosticindex; HR, hazard ratio</p><p>95%CI, 95confidence interval</p><p>Multivariate Cox regression analysis for survival.</p

Kaplan-Meier curve for overall survival (OS) and event-free survival (EFS) according to the expression of CD30 and treatment.

<p>OS (<b>A</b>) and EFS (<b>B</b>) according to CD30 expression in DLBCL patients treated with CHOP. OS (<b>C</b>) and EFS (<b>D</b>) according to CD30 expression in DLBCL patients treated with R-CHOP.</p

Kaplan-Meier curve for overall survival (OS) and event-free survival (EFS) according to the expression of CD30 and IPI.

<p>OS (A) and EFS (B) for high intermediate/high IPI risk patients (IPI = 3–5) with and without CD30 expression; OS (C) and EFS (D) for low/ low intermediate risk IPIpatients (IPI = 0–2)with and without CD30 expression.</p

Kaplan-Meier curve of overall survival (A) and event-free survival (B) in DLBCL patients according to CD30 expression.

<p>Kaplan-Meier curve of overall survival (A) and event-free survival (B) in DLBCL patients according to CD30 expression.</p

Characteristics of patients and transplants.

<p>DLI = donor lymphocyte infusion, CP = chronic phase, AP = accelerated phase, BP = blast phase, Ph = Philadelphia chromosome, GVHD = graft versus host disease.</p

Overall Survival (A) and Disease-free Survival (B) in the imatinib and DLI groups.

<p>The 8-year overall survival (OS) after relapse was 85%±8% and 40.3±12.1% (<i>P</i> = 0.017), 8-year disease-free survival (DFS) after relapse was 85%±8% and 40.3±12.1% (<i>P</i> = 0.011), respectively, in the imatinib and DLI groups.</p

Donor chimerism in imatinib and DLI groups in 1, 2 and 3 months after treatments (<i>P</i> = 0.836, <i>P</i> = 0.691 and <i>P</i> = 0.931).

<p>The median donor chimerism in imatinib and DLI groups was 73% (range 27%–90%) vs 74% (range 47%–89%), 84% (range 11%–95%) vs 84% (range 28%–94%), and 96% (range 0%–100%) vs 97% (range 23%–100%), respectively, in 1, 2 and 3 months after treatments.</p