Correlations Between Immunophenotypic Markers and Clinical Progression in Romanian Patients Diagnosed with Diffuse Large B-Cell Lymphoma

TL;DR

This study examines how specific immune markers relate to disease progression in Romanian patients with a type of lymphoma called diffuse large B-cell lymphoma.

Contribution

The study evaluates the prognostic value of Ki-67, MYC, and BCL2 in a Romanian DLBCL cohort without fluorescence in situ hybridisation.

Findings

High Ki-67 expression correlates with significantly shorter overall survival in DLBCL patients.

BCL2 protein expression shows a trend toward lower survival in positive cases.

Most cases belonged to the non-GCB (ABC) subtype of DLBCL.

Abstract

Diffuse large B-cell lymphoma is a prevalent subtype of adult non-Hodgkin lymphoma; noted for its biological and clinical variability. Background and Objectives: This study seeks to assess the expression and prognostic implications of Ki-67, MYC, and BCL2 utilising immunohistochemistry on a cohort of Romanian patients diagnosed with DLBCL while also addressing the limitations imposed by the absence of fluorescence in situ hybridisation testing in resource-constrained settings. Materials and Methods: A single-centre, retrospective study involved 66 cases of formalin-fixed, paraffin-embedded tissue specimens obtained from patients with this lymphoma. Results: The median age at diagnosis was 61.81 years, with most individuals being 60 years or older; 59.1% of the patients were male. Our study identified that 65.2% of the cases belonged to the non-GCB subtype (ABC). MYC-positive expression was observed in 5 out of 66 cases (7.6%), and BCL2 protein expression exhibited a trend toward statistical significance, indicating a lower overall survival for BCL-2-positive patients. The expression of Ki-67 demonstrated a significant correlation with variations in overall survival (OS) (p < 0.001). Patients with low Ki-67 expression had an average survival duration of 76.39 months, contrasting with individuals exhibiting high Ki-67 expression, with a mean survival of 38.98 months. In conclusion, MYC, BCL2, and Ki-67 may be valuable prognostic indicator biomarkers. Conclusions: The prognostic significance of each biomarker varies based on the established cut-off point value. Future research should examine the relationship between protein biomarkers, morphological characteristics, and clinical outcomes in Romanian patients diagnosed with DLBCL, aiming to elucidate clinical ramifications and foster effective management.

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