Prognostic analysis of CD5 expression in double-hit diffuse large B-cell lymphoma and effectiveness comparison in patients treated with dose-adjusted EPOCH plus rituximab/R-CHOP regimens

Fangwen Zhang,1,2,* Ling Li,1,2,* Lei Zhang,1,2 Xin Li,1,2 Xiaorui Fu,1,2 Xinhua Wang,1,2 Jingjing Wu,1,2 Zhenchang Sun,1,2 Fei Kong,1,2 Liangliang Ren,1,2 Mingzhi Zhang1,21Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, People’s Repu...

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Autores principales:	Zhang F, Li L, Zhang L, Li X, Fu X, Wang X, Wu J, Sun Z, Kong F, Ren L, Zhang M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	CD5 DA-EPOCH-R R-CHOP diffuse large B-cell lymphoma double-hit treatment prognosis Diseases of the blood and blood-forming organs RC633-647.5
Acceso en línea:	https://doaj.org/article/7b40f317ec344a0aaf7018c1756edf7e
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spelling	oai:doaj.org-article:7b40f317ec344a0aaf7018c1756edf7e2021-12-02T07:38:14ZPrognostic analysis of CD5 expression in double-hit diffuse large B-cell lymphoma and effectiveness comparison in patients treated with dose-adjusted EPOCH plus rituximab/R-CHOP regimens1179-9889https://doaj.org/article/7b40f317ec344a0aaf7018c1756edf7e2019-08-01T00:00:00Zhttps://www.dovepress.com/prognostic-analysis-of-cd5-expression-in-double-hit-diffuse-large-b-ce-peer-reviewed-article-BLCTThttps://doaj.org/toc/1179-9889Fangwen Zhang,1,2,* Ling Li,1,2,* Lei Zhang,1,2 Xin Li,1,2 Xiaorui Fu,1,2 Xinhua Wang,1,2 Jingjing Wu,1,2 Zhenchang Sun,1,2 Fei Kong,1,2 Liangliang Ren,1,2 Mingzhi Zhang1,21Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, People’s Republic of China; 2Department of Oncology, Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450052, People’s Republic of ChinaCorrespondence: Ling Li; Mingzhi ZhangDepartment of Oncology, Zhengzhou University First Affiliated Hospital, No. 1 Jianshe East Road , Zhengzhou, Henan 450052, People’s Republic of ChinaEmail lingl510@126.com mingzhi_zhang@126.com*These authors contributed equally to this workObjectives: To compare the efficacy of rituximab, dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA-EPOCH-R) with traditional rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) regimens in CD5+ double-hit lymphoma (DHL) and to evaluate prognostic factors.Methods: We retrospectively studied 139 patients with newly diagnosed DHL/THL diffuse large B-cell lymphoma (including 20 cases CD5+ and 119 cases CD5−), 87 cases were MYC/BCL2 DHL, 30 cases were MYC/BCL6 DHL, 22 cases were THL. MYC, BCL2 and BCL6 rearrangements were examined by fluorescence in-situ hybridization. CD5 is detected by immunohistochemistry (IHC).Results: The objective response rate (ORR) difference between CD5+ and CD5− was significant (80.0% vs 63.8%, P=0.003). The median follow-up time was 18 months (range: 4–39 months). Progression-free survival (PFS) of CD5+ group was significantly worse than that of CD5- (28.1% vs 59.0%, P=0.028), while no significant difference was observed in overall survival (OS) (32.1% vs 59.9%, P=0.057). Compared with the two regimens, the 2-year survival rate of DA-EPOCH-R group was significantly superior than that of R-CHOP (63.6% vs 45.4%, P=0.034 for PFS; 67.4% vs 47.8%, P=0.038 for OS). Besides, CD5+ patients receiving DA-EPOCH-R had survival benefits compared with R-CHOP in PFS (85.7% vs 23.0%, P=0.029), but there was no statistical difference in OS (87.7% vs 34.4.0%, P=0.064). However, in DA-EPOCH-R protocol, there was no significant difference between CD5+ DHL (MYC/BCl2 and MYC/BCL6) and triple-hit lymphoma (P=0.776 for PFS; P=0.728 for OS). Multivariate analysis showed that CD5+ treatment regimen and disease stage were independent prognostic factors.Conclusion: Our retrospective study shows that CD5+ has a poorer prognosis than CD5− patients. Based on its improved lifetime and good tolerance on CD5+ patients, which is expected to become the first-line treatment for high-risk DLBCL types based on more clinical research.Keywords: CD5, DA-EPOCH-R, R-CHOP, diffuse large B-cell lymphoma, double-hit, treatment, prognosisZhang FLi LZhang LLi XFu XWang XWu JSun ZKong FRen LZhang MDove Medical PressarticleCD5DA-EPOCH-RR-CHOPdiffuse large B-cell lymphomadouble-hittreatmentprognosisDiseases of the blood and blood-forming organsRC633-647.5ENBlood and Lymphatic Cancer: Targets and Therapy, Vol Volume 9, Pp 33-43 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	CD5 DA-EPOCH-R R-CHOP diffuse large B-cell lymphoma double-hit treatment prognosis Diseases of the blood and blood-forming organs RC633-647.5
spellingShingle	CD5 DA-EPOCH-R R-CHOP diffuse large B-cell lymphoma double-hit treatment prognosis Diseases of the blood and blood-forming organs RC633-647.5 Zhang F Li L Zhang L Li X Fu X Wang X Wu J Sun Z Kong F Ren L Zhang M Prognostic analysis of CD5 expression in double-hit diffuse large B-cell lymphoma and effectiveness comparison in patients treated with dose-adjusted EPOCH plus rituximab/R-CHOP regimens
description	Fangwen Zhang,1,2,* Ling Li,1,2,* Lei Zhang,1,2 Xin Li,1,2 Xiaorui Fu,1,2 Xinhua Wang,1,2 Jingjing Wu,1,2 Zhenchang Sun,1,2 Fei Kong,1,2 Liangliang Ren,1,2 Mingzhi Zhang1,21Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, People’s Republic of China; 2Department of Oncology, Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450052, People’s Republic of ChinaCorrespondence: Ling Li; Mingzhi ZhangDepartment of Oncology, Zhengzhou University First Affiliated Hospital, No. 1 Jianshe East Road , Zhengzhou, Henan 450052, People’s Republic of ChinaEmail lingl510@126.com mingzhi_zhang@126.com*These authors contributed equally to this workObjectives: To compare the efficacy of rituximab, dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA-EPOCH-R) with traditional rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) regimens in CD5+ double-hit lymphoma (DHL) and to evaluate prognostic factors.Methods: We retrospectively studied 139 patients with newly diagnosed DHL/THL diffuse large B-cell lymphoma (including 20 cases CD5+ and 119 cases CD5−), 87 cases were MYC/BCL2 DHL, 30 cases were MYC/BCL6 DHL, 22 cases were THL. MYC, BCL2 and BCL6 rearrangements were examined by fluorescence in-situ hybridization. CD5 is detected by immunohistochemistry (IHC).Results: The objective response rate (ORR) difference between CD5+ and CD5− was significant (80.0% vs 63.8%, P=0.003). The median follow-up time was 18 months (range: 4–39 months). Progression-free survival (PFS) of CD5+ group was significantly worse than that of CD5- (28.1% vs 59.0%, P=0.028), while no significant difference was observed in overall survival (OS) (32.1% vs 59.9%, P=0.057). Compared with the two regimens, the 2-year survival rate of DA-EPOCH-R group was significantly superior than that of R-CHOP (63.6% vs 45.4%, P=0.034 for PFS; 67.4% vs 47.8%, P=0.038 for OS). Besides, CD5+ patients receiving DA-EPOCH-R had survival benefits compared with R-CHOP in PFS (85.7% vs 23.0%, P=0.029), but there was no statistical difference in OS (87.7% vs 34.4.0%, P=0.064). However, in DA-EPOCH-R protocol, there was no significant difference between CD5+ DHL (MYC/BCl2 and MYC/BCL6) and triple-hit lymphoma (P=0.776 for PFS; P=0.728 for OS). Multivariate analysis showed that CD5+ treatment regimen and disease stage were independent prognostic factors.Conclusion: Our retrospective study shows that CD5+ has a poorer prognosis than CD5− patients. Based on its improved lifetime and good tolerance on CD5+ patients, which is expected to become the first-line treatment for high-risk DLBCL types based on more clinical research.Keywords: CD5, DA-EPOCH-R, R-CHOP, diffuse large B-cell lymphoma, double-hit, treatment, prognosis
format	article
author	Zhang F Li L Zhang L Li X Fu X Wang X Wu J Sun Z Kong F Ren L Zhang M
author_facet	Zhang F Li L Zhang L Li X Fu X Wang X Wu J Sun Z Kong F Ren L Zhang M
author_sort	Zhang F
title	Prognostic analysis of CD5 expression in double-hit diffuse large B-cell lymphoma and effectiveness comparison in patients treated with dose-adjusted EPOCH plus rituximab/R-CHOP regimens
title_short	Prognostic analysis of CD5 expression in double-hit diffuse large B-cell lymphoma and effectiveness comparison in patients treated with dose-adjusted EPOCH plus rituximab/R-CHOP regimens
title_full	Prognostic analysis of CD5 expression in double-hit diffuse large B-cell lymphoma and effectiveness comparison in patients treated with dose-adjusted EPOCH plus rituximab/R-CHOP regimens
title_fullStr	Prognostic analysis of CD5 expression in double-hit diffuse large B-cell lymphoma and effectiveness comparison in patients treated with dose-adjusted EPOCH plus rituximab/R-CHOP regimens
title_full_unstemmed	Prognostic analysis of CD5 expression in double-hit diffuse large B-cell lymphoma and effectiveness comparison in patients treated with dose-adjusted EPOCH plus rituximab/R-CHOP regimens
title_sort	prognostic analysis of cd5 expression in double-hit diffuse large b-cell lymphoma and effectiveness comparison in patients treated with dose-adjusted epoch plus rituximab/r-chop regimens
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/7b40f317ec344a0aaf7018c1756edf7e
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Prognostic analysis of CD5 expression in double-hit diffuse large B-cell lymphoma and effectiveness comparison in patients treated with dose-adjusted EPOCH plus rituximab/R-CHOP regimens

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