The immunohistochemical studies of double or triple protein lymphoma in diffuse large B-cell lymphoma and their correlation with clinicopathological parameters

• Main Author: Wahab, Wan Nor Najmiyah Wan Abdul
• Format: Thesis
• Language: English
• Published: 2017
• Subjects: RC Internal medicine
• Online Access: http://eprints.usm.my/45682/1/Dr.%20Wan%20Nor%20Najmiyah%20Wan%20Abdul%20Wahab-24%20pages.pdf; http://eprints.usm.my/45682/

Background and objective: In recent years, “double hit” and “double protein” involving gene rearrangement and protein expression of MYC and BCL2 and/or BCL6 are the most used terms to describe poor prognostic factors in diffuse large B-cell lymphoma (DLBCL) This current study is to determine the frequency of double or triple protein expression by using immunohistochemistry (IHC) and relating the result with clinicopathological features and cell of origin (COO) classification. Material and methods: We conducted a cross sectional study by using 29 archived formalin-fixed paraffin embedded tissue blocks of DLBCL. All the samples were evaluated for expression of MYC, BCL2 and BCL6 by IHC. In addition, the subgrouping of COO DLBCL was determined by expression of CD10, BCL6 and MUM1 based on Hans classification. Result: Among the 29 cases, MYC, BCL2 and BCL6 proteins were detected in 72.4%, 62.1% and 62.1% of patients, respectively. Concurrent expression (MYC positive/BCL2 positive and/or BCL6 positive) was present in 58.6% of patients. 34.5% were categorized as germinal centre like (GCB) subgroup and 65.5% were categorized as non germinal centre like (non-GCB) subgroup. Among the clinicopathological features, the double/triple protein expression lymphoma was significantly associated with elevated LDH level (p=0.018), IPI score (p=0.003), Ann Arbor stage (p=0.011) and complete response rate (p=0.011Conclusion: Double/triple protein lymphoma was strongly associated more adverse clinical risk factors. Thus, analyses of MYC, BCL2 and BCL6 expression by IHC represents a rapid and inexpensive approach to risk-stratify patients with DLBCL at diagnosis.