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Switching to BCL-6 Negativity in Relapsed Diffuse Large B Cell Lymphoma Correlated with More Aggressive Disease Course

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Indian Journal of Hematology and Blood Transfusion Aims and scope Submit manuscript

Abstract

Diffuse large B-cell lymphoma (DLBCL) is the most frequent, complex and heterogeneous lymphoma of adulthood. Heterogeneity is expressed at clinical, genetic, and molecular levels. It is known that BCL-6 expression is a favorable prognostic factor in DLBCL. However, the underlying mechanisms of BCL-6 expression in DLBCL relapse are not yet elucidated. Here, we present so far undescribed clinical phenomenon of switching BCL-6+ protein expression into BCL-6− expression in 19 of 41 relapsed DLBCL patients. The switch in relapsed DLBCL was associated with more aggressive clinical course of the disease. Bone marrow infiltration and high IPI risk were more often present in BCL-6− patients. Significantly increased biochemical parameters, such as LDH, beta-2 macroglobulin, CRP, and ferritin have been found, as well as significantly decreased serum Fe, TIBC, and hemoglobin. A Ki-67 proliferation marker was considerably high in relapsed DLBCL, but without significant differences between BCL-6+ and BCL-6− groups of patients. Thus, switching of the positive into negative BCL-6 expression during DLBCL relapse could be used as a prognostic factor and a valuable criterion for treatment decision.

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Acknowledgments

This work was supported from the Ministry of Science of Serbia (Project No 41004).

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Authors and Affiliations

  1. Clinic for Hematology, Clinical Center of Serbia, Koste Todorovica 2, 11000, Belgrade, Serbia

    Milena Todorović, Bosko Andjelic & Biljana Mihaljevic

  2. Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Milena Todorović & Biljana Mihaljevic

  3. Institute for Transfusiology and Hemobiology of MMA, Belgrade, Serbia

    Bela Balint

  4. Institute for Medical Research, University of Belgrade, Belgrade, Serbia

    Bela Balint

  5. Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Ziv Radisavljevic

Authors
  1. Milena Todorović
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  2. Bela Balint
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  3. Bosko Andjelic
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  4. Ziv Radisavljevic
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  5. Biljana Mihaljevic
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Correspondence to Milena Todorović.

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Todorović, M., Balint, B., Andjelic, B. et al. Switching to BCL-6 Negativity in Relapsed Diffuse Large B Cell Lymphoma Correlated with More Aggressive Disease Course. Indian J Hematol Blood Transfus 30, 269–274 (2014). https://doi.org/10.1007/s12288-014-0346-8

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  • DOI: https://doi.org/10.1007/s12288-014-0346-8

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