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Clinicopathologic implication of PD-L1 gene alteration in primary adrenal diffuse large B cell lymphoma

Cited 1 time in Web of Science Cited 1 time in Scopus
Authors

Lee, Ki Rim; Koh, Jiwon; Jeon, Yoon Kyung; Kwon, Hyun Jung; Lee, Jeong-Ok; Paik, Jin Ho

Issue Date
2022-01
Publisher
대한병리학회
Citation
Journal of Pathology and Translational Medicine, Vol.56 No.1, pp.32-39
Abstract
Background: Primary adrenal (PA) diffuse large B cell lymphoma (DLBCL) was previously reported as an aggressive subset of DLBCL, but its genetic features were not sufficiently characterized. From our previous study of DLBCL with programmed death-ligand 1 (PD-L1) gene alterations, we focused on PD-L1 gene alterations in PA-DLBCL with clinicopathologic implications. Methods: We performed fluo-rescence in situ hybridization for PD-L1 gene translocation and amplification in PA-DLBCL (n = 18) and comparatively analyzed clinico-pathologic characteristics with systemic non-adrenal (NA)-DLBCL (n = 90). Results: PA-DLBCL harbored distinctive features (vs. NA-DLBCL), including high international prognostic index score (3-5) (72% [13/18] vs. 38% [34/90], p = .007), poor Eastern Cooperative Oncology Group performance score (>= 2) (47% [7/15] vs. 11% [10/90], p = .003), elevated serum lactate dehydrogenase (LDH) (78% [14/18] vs. 51% [44/87], p = .035) and MUM1 expression (87% [13/15] vs. 60% [54/90], p = .047). Moreover, PA-DLBCL showed frequent PD-L1 gene alterations (vs. NA-DLBCL) (39% [7/18] vs. 6% [5/86], p = .001), including translocation (22% [4/18] vs. 3% [3/87], p = .016) and amplification (17% [3/18] vs. 2% [2/87], p = .034). Within the PA-DLBCL group, PD-L1 gene-altered cases (vs. non-altered cases) tended to have B symptoms (p = .145) and elevated LDH (p = .119) but less frequent bulky disease (>= 10 cm) (p = .119). In the survival analysis, PA-DLBCL had a poor prognosis for overall survival (OS) and progression-free survival (PFS) (vs. NA-DLBCL; p = .014 and p = .004). Within the PA-DLBCL group, PD-L1 translocation was associated with shorter OS and PFS (p < .001 and p = .012). Conclusions: PA-DLBCL is a clinically aggressive and distinct subset of DLBCL with frequent PD-L1 gene alterations. PD-L1 gene translocation was associated with poor prognosis in PA-DLBCL.
ISSN
2383-7837
URI
https://hdl.handle.net/10371/191856
DOI
https://doi.org/10.4132/jptm.2021.10.05
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  • College of Medicine
  • Department of Medicine
Research Area Head and Neck Pathology, Hematopathology, Renal Pathology

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