At the 2023 American Society of Clinical Oncology (ASCO) annual meeting in Chicago, Illinois, Won Jin Jeon, MD, Loma Linda University, Loma Lida, California, presented data from a systematic analysis that demonstrated the significant prognostic value of BCL6 for mantle cell lymphoma (MCL) treatment, compared with the value of CD10. 

Transcript:

Hello, my name is Dr. Won Jin Jeon. I'm from Loma Linda University, the division of hematology and oncology. I'm here to tell you about a poster we presented at ASCO 2023. Our paper, an abstract actually, is on the prognostic significance of BCL6-positive and CD10-positive mantle cell lymphoma as a systematic analysis. We found that, at our institution, there are several patients with mantle cell lymphoma who have variants with CD10-positive mantle cell lymphoma. We noticed that there are papers in the literature that talk about the significance of CD10 positivity, specifically with survival outcomes. When we looked at the papers, we noticed that there are mixed results, some are literature saying that there are worse outcomes, and others saying that there are better outcomes or they're about the same.

We did a systematic analysis at our database. At our institution, we were able to look at the literature that's currently out there. We were able to identify 10 articles where there are cases of patients with survival outcomes and CD10-positive MCL variants. When we looked at the data and the patient characteristics, we noted that CD10-positive versus CD10-negative patients did not really have major differences. The main difference that we saw was that, with CD10-positive MCL, there were possibly more patients with different morphologic variants of MCL, specifically. We noticed that there were more patients with CD10-positive MCL that had morphologic differences in variants, such as the pleomorphic variant. Otherwise, we noted that CD10 by itself, whether it's positive or negative, does not lead to any differences in survival.

As we continued our analysis, we looked at other markers, such as BCL6, MUM1, and SOX11, and interestingly found that with BCL6 positivity, there might be a clue to what we're looking at here in terms of survival outcomes. So specifically, we found that patients with BCL6-positive MCL compared to BCL6-negative MCL had worse median overall survival. 

When we plotted it in a Kaplan-Meier curve, we found that the median overall survival for patients with BCL6-positive MCL was about 14 months compared to 43 months with patients who had BCL6-negative MCL, and that was statistically significant. We didn't want to forget about the CD10 positivity, though, and those patients with that variant. This time, we looked at patients with CD10 positivity, but BCL6-positive versus BCL6-negative, meaning that all the patients had CD10-positive MCL. We looked at the mitotic index and the Ki-67 percentages and found that patients with BCL6-positive and CD10-positive co-expression. Patients with both the core expression of BCL6 and CD10 had higher levels of the Ki-67 percentage, possibly alluding to the fact that they are associated with worse outcomes.

Overall, we were able to figure out that BCL6 may be a key factor in leading to the prognostic changes or outcomes in our patients with mantle cell lymphoma, more than CD10. We would suggest that future directions of our study would be looking at BCL6, BCL-positive or negative. Some of the future directions that we have with our paper and abstract [are] that we'll look at patients with BCL6-positive and negative MCL, and go a bit further into the molecular and genetic profiles of these patients to figure out what is it exactly with BCL6 positivity that leads to the worst prognosis? What are some things that we can do to prevent or even prognosticate the patients prior to starting treatment? Thank you.

Source: 

Jeon WJ, Castillo DR, Park D, et al. Unveiling the prognostic significance of BCL6+/CD10+ mantle cell lymphoma: A systematic analysis. Presented at the ASCO Annual Meeting; June 2-6, 2023; Chicago, Illinois. Abstract 7572