Prognostic impacts of BCL2, MYC, P53, CD5 and CD30 expressions in nodal diffuse large B cell lymphoma, NOS

Aim: It was aimed to determine the expressions of BCL2, MYC, CD30, CD5 and P53 in diffuse large B-cell lymphoma, not otherwise specified (DLBCL,NOS) to examine the relationship of these markers with the prognostic data of the patients and to determine their prognostic values in DLBCL,NOS cases. Material and methods: A total of 71 nodal DLBCL,NOS cases diagnosed between 2001 and 2021 with no known extranodal involvement at the time of diagnosis were evaluated. Clinical prognostic data were obtained in 61 of these cases. BCL2, MYC, CD30, CD5 and P53 expressions were performed by immunohistochemical method. The relationships between immunohistochemical data and clinical prognostic parameters, also their effects on overall survival were investigated. Results: It was observed that MYC positive (p=0.023) and P53 positive cases (p=0.042) had significantly worse overall survival (OS). BCL2 positive cases were found to be associated with worse OS than BCL2 negative cases (p=0,073). CD30 positive cases had significantly better overall survival (p=0.015). It was found that the poor prognostic impacts of MYC and P53 were independent of other markers and IPI score. In addition, cases that are >60 years of age, that have high LDH level, ECOG performance score, stage, IPI score; <3,95 g/dL albumin level, <12,35 g/dL hemoglobin level, <1510/μL peripheral blood lymphocyte count, <%20 CD3 positive cells-all lymphoid cells ratio were found to have worse overall survival. Conclusion: In our study, it was concluded that MYC and P53 can be used as markers that predict poor prognosis in DLBCL,NOS. Their prognostic impacts were independent of the IPI score. It was thought that cases expressing both of these two markers could be considered as a separate group with worse prognosis. It was concluded that investigating BCL2 is also necessary for identifying double-expressor cases with poor prognosis, in order to recommend translocation analysis. Additionally, lower CD3 density was found to be associated with worse overall survival. It is suggested to use a new risk scoring system consisting of MYC, P53, CD3 and NCCN-IPI score to achieve the most prognostically significant results in DLBCL,NOS. Keywords: Diffuse large B cell lymphoma, MYC, BCL2, CD5, CD30, P53