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IHC-Detected BCL2 Expression a Biomarker for Outcomes in HIV-Associated DLBCL
Study findings support the evaluation of novel strategies for the treatment of patients with HIV-associated diffuse large B-cell lymphoma (DLBCL) expressing BCL-2 (Br J Haematol. 2020;188[3]:413-423).
“The prognostic value of cell of origin (COO) classification and BCL2 expression is not well established in [DLBCL] patients with [HIV] infection in the recent era,” wrote Laure Philippe, MD, Unit of Haematology-Oncology, Centre Hospitalier Versailles, Le Chesnay, France, and colleagues.
Using immunohistochemistry (IHC) of 52 pathologic samples from patients with HIV-associated DLBCL enrolled in the French AIDS and Viral Hepatitis CO16 Lymphovir cohort between 2008 and 2015, Dr Philippe et al found phenotypic patterns.
“Molecular subgroup classification into germinal centre B-cell (GCB) and non-GCB subtypes was determined using the Hans algorithm,” they explained.
Among 42 samples tested for BCL2 expression, 25 were positive; these samples were then further classified into GCB (n = 19) and non-GCB (n = 16) subtypes, with 17 deemed unclassified.
According to multivariable analysis, BCL2 expression was an independent, negative, prognostic biomarker and had a tendency to reduce 4-year overall survival (OS; 4-year progression-free survival [PFS], 52% for BCL2+ vs 88% for BCL2- ; P = .02 and 63% for BCL2+ vs 88% for BCL2- ; P = .06).
Furthermore, PFS and OS differences between CGB and non-GCB subtypes were not significant (4-year PFS, 79% for GCB vs 53% for non-GCB; P = .24 and 4-year OS, 78% for GCB vs 69% for non-GCB; P = .34).
“BCL2 expression determined by IHC is an independent pejorative prognostic biomarker in HIV-associated DLBCL in the recent era,” Dr Philippe and colleagues wrote.
“This supports the investigation of new therapeutic strategies in patients with BCL2 expression,” they concluded.—Hina Porcelli
