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Journal of Neuro-Oncology

, Volume 140, Issue 1, pp 115–121 | Cite as

BCL2 expression is associated with a poor prognosis independent of cellular origin in primary central nervous system diffuse large B-cell lymphoma

  • Keishi Makino
  • Hideo Nakamura
  • Naoki Shinojima
  • Jun-ichiro Kuroda
  • Shigetoshi Yano
  • Yoshiki Mikami
  • Akitake Mukasa
Clinical Study

Abstract

Purpose

Primary central nervous system diffuse large B-cell lymphoma (CNS-DLBCL) is a distinct clinicopathological entity with a poor prognosis. Concurrent MYC and BCL2 overexpression predicts inferior prognosis in systemic DLBCL, although their prognostic significance remains unclear in primary CNS-DLBCL.

Methods

Pretreatment diagnostic biopsy samples were retrospectively evaluated for 79 patients with primary CNS-DLBCL who were treated between January 2001 and December 2017. Histological and immunohistochemical testing were performed to evaluate the patients’ statuses for various markers, which were also evaluated for associations with survival outcomes.

Results

According to the Hans criteria, 26 patients (32.9%) had the germinal center B-cell subtype and 53 patients (67.1%) had the activated B-cell subtype. Forty-one cases (51.9%) were positive for MYC (expression of ≥ 40%), 33 cases (41.8%) were positive for BCL2 (expression of ≥ 70%), 22 patients (27.8%) were positive for both MYC and BCL2, and 27 patients (34.2%) were negative for both MYC and BCL2. There were no significant differences in survival between the germinal center and activated B-cell subtypes. Furthermore, MYC positivity was not associated with overall survival (p = 0.369) or progression-free survival (PFS) (p = 0.253). However, BCL2 positivity was significantly associated with poor overall survival (p = 0.039) and PFS (p = 0.036). Co-expression of MYC and BCL2 was not associated with survival.

Conclusion

Our data suggest that evaluating BCL2 expression may help predict the prognosis in cases of primary CNS-DLBCL.

Keywords

Primary central nervous system lymphoma MYC BCL2 Immunohistochemistry Cell of origin 

Notes

Acknowledgements

We thank Ms. Masayo Obata for her histological assistance.

Funding

This work was supported by Grants-in-Aid for Scientific Research(C) to KM (17K10870).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurosurgeryKumamoto UniversityKumamotoJapan
  2. 2.Department of Diagnostic PathologyKumamoto University HospitalKumamotoJapan

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