Clinicopathologic analysis of CD10+ and CD10- diffuse large B-cell lymphoma: Identification of a high-risk subset with coexpression of CD10 and bcl-2

• Published in: American journal of clinical pathology Vol. 116; no. 2; pp. 183 - 190
• Main Authors: YIN XU, MCKENNA, Robert W, MOLBERG, Kyle H, KROFT, Steven H
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Society of Clinical Pathologists 01.08.2001
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Child; Child, Preschool; Female; Flow Cytometry; Hematologic and hematopoietic diseases; Humans; Immunohistochemistry; Immunophenotyping; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, B-Cell - immunology; Lymphoma, B-Cell - metabolism; Lymphoma, B-Cell - pathology; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - immunology; Lymphoma, Large B-Cell, Diffuse - pathology; Male; Medical sciences; Middle Aged; Neprilysin - analysis; Proto-Oncogene Proteins c-bcl-2 - analysis; Remission Induction; Survival Rate; Diffuse; Human; Immunohistochemistry; Flow cytometry; Prognosis; Malignant hemopathy; B-Lymphocyte; Large cell lymphoma; Non Hodgkin lymphoma; Gene expression; Pathology; Lymphoproliferative syndrome; Clinical investigation; Comparative study; Apoptosis
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1309/j7rn-uxay-55gx-bunk

We analyzed 53 cases of diffuse large B-cell lymphoma (DLBCL) to determine whether expression of CD10 is a relevant biologic parameter. Tumor morphologic features were assessed semiquantitatively. Bcl-2 protein expression was studied by immunohistochemical analysis. The presence or absence of CD10 by flow cytometry was correlated with clinical and pathologic characteristics. CD10+ (23 cases) and CD10- (30 cases) DLBCLs were indistinguishable based on age, sex, extranodal presentation, B symptoms, clinical stage, morphologic features, or bcl-2 expression. However, cases with a CD10+ phenotype showed a significantly lower rate of complete remission. Cases expressing bcl-2 showed trends toward a lower rate of complete remission and poorer overall survival. Examination of CD10 and bcl-2 interaction revealed that the prognostic effects for both of these antigens were due to a subset of CD10+ bcl-2-positive cases. Compared with cases expressing one or neither of these markers, patients with dual-positive tumors had a poorer complete response rate to initial therapy and strikingly worse overall survival. While CD10+ and CD10- DLBCLs are similar with regard to a variety of clinical and pathologic features, CD10 and bcl-2 coexpressing tumors are an extremely high-risk subset based on response to therapy and overall survival.