Prognostic significance of PCR-based molecular staging in patients with diffuse large B-cell lymphoma treated with R-CHOP immunochemotherapy

Abstract

The prognostic role of detecting clonal immunoglobulin gene rearrangement (IgR) from bone marrow (BM) aspirates was evaluated by BIOMED-2 PCR in 97 patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab-CHOP immunochemotherapy. Sixteen (16.5%) patients had BM involvement (BMI) defined by BM biopsy (MOR+) and 39 (40.2%) had positive IgR (PCR+). Patients with MOR + BMI showed inferior event-free survival (EFS) compared to those with MOR−/PCR− (p < 0.001) or those with MOR−/PCR + BMI (p = 0.002), while no significant difference in EFS was observed between patients with MOR−/PCR + and those with MOR−/PCR − BMI (p = 0.497). Use of the BIOMED-2 for PCR resulted in significant increase in detection of BMI. However, the increased sensitivity by PCR did not translate into improved prediction of prognosis, emphasizing the essential role of histopathological review of trephine biopsy for the detection of BMI.

Keywords:

• BIOMED-2
• bone marrow involvement
• clonality
• diffuse large B-cell lymphoma
• prognosis

Acknowledgements

The authors are indebted to Bong Soon Heo, a medical laboratory technologist in the Department of Laboratory Medicine and Ji Yoon Park, a research assistant in the Hematology division of GUGMC.

Compliance with Ethical Standards

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional or national research committee and with the Helsinki Declaration of 1964, and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the studies.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at http://dx.doi.org/10.1080/10428194.2016.1190967.