Human leukocyte antigen-DR expression on flow cytometry and tumor-associated macrophages in diffuse large B-cell lymphoma treated by rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone therapy: retrospective cohort study

• Published in: Leukemia & lymphoma Vol. 55; no. 12; pp. 2721 - 2727
• Main Authors: Yamamoto, Wataru, Nakamura, Naoya, Tomita, Naoto, Takeuchi, Kengo, Ishii, Yoshimi, Takahashi, Hiroyuki, Watanabe, Reina, Takasaki, Hirotaka, Motomura, Shigeki, Kobayashi, Shoichi, Yokose, Tomoyuki, Ishigatsubo, Yoshiaki, Sakai, Rika
• Format: Journal Article
• Language: English
• Published: United States Informa Healthcare 01-12-2014; Taylor & Francis
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal, Murine-Derived - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cyclophosphamide - therapeutic use; diffuse large B-cell lymphoma; Doxorubicin - therapeutic use; Female; flow cytometry; HLA-DR; HLA-DR Antigens - immunology; HLA-DR Antigens - metabolism; Humans; Immunohistochemistry; Immunophenotyping; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - immunology; Lymphoma, Large B-Cell, Diffuse - metabolism; Lymphoma, Large B-Cell, Diffuse - mortality; Lymphoma, Large B-Cell, Diffuse - pathology; Macrophages - immunology; Macrophages - metabolism; Male; Middle Aged; Neoplasm Staging; Phenotype; Prednisone - therapeutic use; Prognosis; R-CHOP therapy; Retrospective Studies; Treatment Outcome; tumor-associated macrophage; Vincristine - therapeutic use; tumor-associated macrophage; flow cytometry; diffuse large B-cell lymphoma; HLA-DR; R-CHOP therapy
• ISSN: 1042-8194; 1029-2403
• DOI: 10.3109/10428194.2014.893311

Abstract
Loss of human leukocyte antigen (HLA)-DR expression may be related to a poor prognosis of diffuse large B-cell lymphoma (DLBCL), and tumor-associated macrophages (TAMs) may influence tumor progression. We retrospectively reviewed 36 patients with newly diagnosed DLBCL who received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) therapy at Kanagawa Cancer Center in Japan from 2004 to 2010. HLA-DR expression by lymphoma cells was evaluated using flow cytometry, and TAMs in lymphoma tissue were detected by immunohistochemistry for CD68 as a marker of macrophages and CD163 as a marker of M2 TAMs. Three-year overall survival was, respectively, 100% versus 69.6% in the HLA-DR "bright" and "not bright" groups (p = 0.012). Patients from the HLA-DR "not bright" group with strong CD163 expression had a much worse prognosis than other patients. The HLA-DR status shown by flow cytometry can be used to predict the prognosis of patients with DLBCL receiving R-CHOP therapy and prognostic accuracy can be increased by also assessing TAMs.