Protein Kinase C Beta II Expression in Diffuse Large B-Cell Lymphoma Predicts for Inferior Outcome of Anthracycline-Based Chemotherapy With And Without Rituximab

Protein kinase C beta II expression in diffuse large B-cell lymphoma has prognostic significance not only for CHOP therapy in low-risk International Prognostic Index disease but also for all patients receiving CHOP plus rituximab.

Full Abstract

Introduction

Protein kinase C beta II (PKCbII) expression has been reported to indicate inferior prognosis in diffuse large B-cell lymphoma (DLBCL) treated with anthracycline-based chemotherapy.

Aim

To compare the prognostic significance of immunohistochemically determined PKCbII expression in de novo DLBCL treated with CHOP chemotherapy (cyclophosphamide/doxorubicin/vincristine/prednisone) with and without rituximab.

Patients and Methods

80 consecutive patients treated at St. Vincent's Hospital with de novo DLBCL, 48 treated with CHOP, and 32 with R-CHOP (rituximab plus CHOP), were studied using immunohistochemistry for PKCbII on diagnostic tissue samples. Staining results were correlated with patient characteristics and clinical outcome. Overall survival (OS) and progression-free survival (PFS) were determined by the Kaplan-Meier method, and comparisons were determined by the log-rank test.

Results

PKCbII expression correlated with inferior OS and PFS in CHOP-treated patients with low-risk International Prognostic Index (IPI) disease (0–2 adverse factors) but not in the overall patient group unstratified by IPI. PKCbII expression significantly correlated with inferior OS and PFS in R-CHOP—treated patients unstratified by IPI status.

Conclusion

PKCbII expression has prognostic significance not only for CHOP therapy in low-risk IPI disease but also for all patients receiving R-CHOP. Immunohistochemically demonstrated PKCbII expression thus identified patient subgroups in which alternative treatment strategies might confer superior outcome.