Abstract
Prognostic markers identify subgroups of patients with similar risk profiles, helping to guide clinical care. The addition of rituximab to conventional anthracycline-based chemotherapy has improved clinical outcomes for patients with diffuse large B-cell lymphoma (DLBCL). Studies suggest that rituximab eliminates or modulates the significance of some markers (eg, BCL6 or BCL2), whereas other previously unimportant markers may emerge as significant prognostic indicators in the setting of treatment that now includes rituximab. These changes in the prognostic profile are likely to reflect the impact of rituximab on survival pathways important to some groups of patients with DLBCL but not to other groups, and thereby may provide clues to the underlying biology of the disease. They also identify subgroups of patients likely to benefit most from rituximab therapy and those who seem to garner no advantage from its inclusion in their treatment. Studies of prognostic indicators in the context of modern therapy have the potential to identify new, rational therapeutic targets for this biologically diverse disease.
MeSH terms
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Antibodies, Monoclonal / administration & dosage
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Antibodies, Monoclonal / therapeutic use*
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Antibodies, Monoclonal, Murine-Derived
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Antineoplastic Combined Chemotherapy Protocols / administration & dosage
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Biomarkers, Tumor / blood*
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Combined Modality Therapy
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Cyclin-Dependent Kinase Inhibitor p21 / blood
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Cyclin-Dependent Kinase Inhibitor p21 / physiology
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Cyclophosphamide / administration & dosage
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DNA-Binding Proteins / blood*
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DNA-Binding Proteins / genetics
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DNA-Binding Proteins / physiology
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Doxorubicin / administration & dosage
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Genes, bcl-2
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Genes, p53
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Humans
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Immunologic Factors / administration & dosage
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Immunologic Factors / therapeutic use*
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Immunotherapy
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L-Lactate Dehydrogenase / blood
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Lymphoma, Large B-Cell, Diffuse / blood
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Lymphoma, Large B-Cell, Diffuse / drug therapy
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Lymphoma, Large B-Cell, Diffuse / genetics
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Lymphoma, Large B-Cell, Diffuse / mortality*
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Multicenter Studies as Topic
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Neoplasm Proteins / blood*
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Neoplasm Proteins / genetics
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Neoplasm Proteins / physiology
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Prednisone / administration & dosage
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Prognosis
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Proto-Oncogene Proteins c-bcl-2 / blood*
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Proto-Oncogene Proteins c-bcl-2 / physiology
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Proto-Oncogene Proteins c-bcl-6
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Randomized Controlled Trials as Topic
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Retrospective Studies
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Rituximab
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Survival Analysis
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Tumor Suppressor Protein p53 / blood*
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Tumor Suppressor Protein p53 / physiology
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Vincristine / administration & dosage
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beta 2-Microglobulin / analysis
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Murine-Derived
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BCL6 protein, human
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Biomarkers, Tumor
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CDKN1A protein, human
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Cyclin-Dependent Kinase Inhibitor p21
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DNA-Binding Proteins
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Immunologic Factors
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Neoplasm Proteins
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Proto-Oncogene Proteins c-bcl-2
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Proto-Oncogene Proteins c-bcl-6
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TP53 protein, human
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Tumor Suppressor Protein p53
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beta 2-Microglobulin
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Rituximab
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Vincristine
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Doxorubicin
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Cyclophosphamide
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L-Lactate Dehydrogenase
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Prednisone