J Pathol Transl Med.  2022 Sep;56(5):281-288. 10.4132/jptm.2022.07.26.

Prognostic significance of BLK expression in R-CHOP treated diffuse large B-cell lymphoma

• Choi S
• Lee YJ
• Choi Y
• Kim M
• Kim HJ
• Kim JE
• Oh S
• Chae SW
• Cha HJ
• Jo JC

• KMID: 2533704
• DOI: http://doi.org/10.4132/jptm.2022.07.26

Abstract

Background
The aim of the present study was to evaluate the prognostic significance of B-cell lymphocyte kinase (BLK) expression for survival outcomes in diffuse large B-cell lymphoma (DLBCL) patients treated with R-CHOP.
Methods
We retrospectively analyzed the medical records of 89 patients from two tertiary referral hospitals. The expression of BLK, SYK, and CDK1 were evaluated in a semiquantitative method using an H-score, and the proportions of BCL2 and C-MYC were evaluated.
Results
A total of 89 patients received R-CHOP chemotherapy as a first-line chemotherapy. The expression rates of BLK in tumor cells was 39.2% (n = 34). BLK expression status was not significantly associated with clinical variables; however, BLK expression in tumor cells was significantly associated with the expression of both C-MYC and BCL2 (p = .003). With a median follow-up of 60.4 months, patients with BLK expression had significantly lower 5-year progression-free survival (PFS) and overall survival rates (49.8% and 60.9%, respectively) than patients without BLK expression (77.3% and 86.7%, respectively). In multivariate analysis for PFS, BLK positivity was an independent poor prognostic factor (hazard ratio, 2.208; p = .040).
Conclusions
Here, we describe the clinicopathological features and survival outcome according to expression of BLK in DLBCL. Approximately 39% of DLBCL patients showed BLK positivity, which was associated as a predictive marker for poor prognosis in patients who received R-CHOP chemotherapy.

Keyword

large B-cell lymphoma; Immunohistochemistry

Figure

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  Fig. 1 B-cell lymphocyte kinase (BLK), CDK1, and SYK expression in diffuse large B-cell lymphoma tissues. (A) Positivity of BLK expression (Inlet box is × 400 magnification). (B) Negativity of BLK expression. (C) Positivity of CDK1 expression. (D) Negativity of CDK1 expression. (E) Positivity of SYK expression. (F) Negativity of SYK expression.

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  Fig. 2 Survival outcomes according to B-cell lymphocyte kinase (BLK) expression: (A) progression-free survival (PFS) and (B) overall survival (OS).

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  Fig. 3 Survival outcomes according to the expression of B-cell lymphocyte kinase (BLK) and double expression of C-MYC and BCL2: (A) progression-free survival (PFS) and (B) overall survival (OS).

Reference

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