Clinicopathologic Features and Genomic Signature of De Novo CD5+ Diffuse Large B-Cell Lymphoma: A Multicenter Collaborative Study. (26th November 2022)

• Record Type: Journal Article
• Authors: Sang, Wei; Ma, Yuhan; Wang, Xiangmin; Ma, Yuanyuan; Shen, Ziyuan; Gu, Weiying; Wang, Fei; Ye, Jingjing; Zhang, Cuijuan; Miao, Yuqing; Xu, Chuanhai; Liu, Qinhua; Li, Bingzong; Tu, Jian; Wang, Chunling; Shi, Yuye; Sun, Su'an; Yan, Dongmei; Song, Xuguang; Sun, Cai; Shao, Yang; Xu, Linyan; Li, Zhenyu; Ma, Dongshen; Xu, Kailin; Young, Ken H.; Liu, Hui
• Is Part Of: American journal of surgical pathology. Volume 46:Number 11(2022)
• Page Start: 1533
• Page End: 1544
• Publication Date: 2022-11-26
• Subjects: CD5 -- diffuse large B-cell lymphoma -- clinicopathologic characteristics -- genomic profiling; Pathology, Surgical -- Periodicals; 617.0705
• DOI: 10.1097/PAS.0000000000001957
• Languages: English
• ISSNs: 0147-5185

Abstract

Abstract : De novo CD5 + diffuse large B-cell lymphoma (DLBCL) has poor survival in the era of immunochemotherapy. Accurate gene-based typing and prognostic stratification can enhance the development of effective individualized treatments. Therefore, we conducted a multicenter retrospective study to evaluate the clinicopathologic characteristics, genomic profiles, and prognostic parameters of 61 patients with CD5 + DLBCL and 60 patients with CD5 − DLBCL, with the goal of facilitating accurate prognostic stratification and potential individualized treatment strategies. Compared with patients with CD5 − DLBCL, older age, advanced stage, higher incidence of central nervous system involvement, and MYC/BCL-2 and p53 overexpression were more prevalent in CD5 + DLBCL. Most patients with CD5 + DLBCL had lymph nodes with non–germinal center B-cell–like or activated B-cell–like subtype according to immunohistochemistry or Lymph2Cx assay. Next-generation sequencing showed that the proportion of MCD subtype (based on the co-occurrence of MYD88 and CD79B mutations) in the CD5 + DLBCL cohort was higher than that in the CD5 − DLBCL cohort (54.2% vs. 13.0%, P =0.005). Compared with the CD5 − cohort, CD5 + DLBCL patients showed poor 5-year overall survival (70.9% vs. 39.0%, P <0.001). Kaplan-Meier survival analysis indicated that cell of origin, MYC/BCL-2, p53, and BCL-6 expression did not have a prognostic impact on patients with CD5 + DLBCL. Multivariate analysis showed that age above 76 years, advanced stage, higher incidence of central nervous system involvement, and hypoalbuminemia were independent factors for poor prognosis in CD5 + DLBCL patients. In summary, CD5 + DLBCL displays poor prognosis, distinctive clinicopathologic characteristics and predominant genetic features of activated B-cell–like and MCD subtypes with worse survival outcome.