Role of Cell-Origin Profiling Using Immunohistochemistry to Predict the Survival of Patients with Diffuse Large B-Cell Lymphoma in Indonesia

Hermawan Istiadi; Udadi Sadhana; Dik Puspasari; Ika Pawitra Miranti; Vega Karlowee; Devia Eka Listiana; Awal Prasetyo

doi:10.33160/yam.2021.05.014

Role of Cell-Origin Profiling Using Immunohistochemistry to Predict the Survival of Patients with Diffuse Large B-Cell Lymphoma in Indonesia

Yonago Acta Med. 2021 May 20;64(2):200-206. doi: 10.33160/yam.2021.05.014. eCollection 2021 May.

Authors

Hermawan Istiadi¹, Udadi Sadhana¹, Dik Puspasari², Ika Pawitra Miranti¹, Vega Karlowee¹, Devia Eka Listiana², Awal Prasetyo¹

Affiliations

¹ Anatomical Pathology Department, Faculty of Medicine, Diponegoro University, Semarang 50244, Indonesia.
² Anatomical Pathology Laboratory, Kariadi General Hospital, Semarang 50244, Indonesia.

Abstract

Background: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma in Asia and Indonesia. DLBCL could be further classified according to cell of origin as the germinal center B-cell (GCB) subtype or the non-germinal center B-cell (non-GCB) subtypes; of these, the non-GCB subtype usually has poorer prognosis. The purpose of this study is to determine the relationship between the cell-origin subtype and 3-year overall survival of patients with DLBCL at Kariadi General Hospital Semarang.

Methods: This research represents an observational analytical study of 36 patients with DLBCL who visited Kariadi General Hospital between January and August 2017. Data on age of diagnosis, tumor location, disease stage, and 3-year overall survival were collected. DLBCL subtype was determined via immunohistochemical examination of CD10, BCL6, and MUM1 protein expression. Data analyses, including the chi squared test and Kaplan-Meier curves, were conducted.

Results: The study population included 18 patients with GCB-subtype DLBCL and 18 patients with non-GCB-subtype DLBCL. No significant difference (P = 0.171) between disease stage and cell-origin subtype was noted between groups. Patients with the non-GCB subtype had a 3-year overall survival that was significantly worse than that of patients with the GCB subtype (P = 0.026). Moreover, the 3-year survival rate of patients with the non-GCB subtype of the disease was 38.9% while that of patients with the GCB subtype was 77.8%. Patients with advanced stages of DLBCL also had a 3-year overall survival that was significantly worse than those of patients with early stages of the disease (P < 0.001), with the 3-year survival rate of patients with advanced stage was 14.3%.

Conclusion: Patients with non-GCB-subtype DLBCL or advanced stages of the disease have a lower 3-year overall survival rate and poorer prognosis compared with those with other subtypes or earlier stages of the disease.

Keywords: Indonesia; diffuse; large B-cell; lymphoma; survival rate.