Origins research in large cell lymphoma-time for action?

摘要

Change happens slowly in the specialty of diffuse large B-cell lymphoma (DLBCL), but some important new therapeutic developments are imminent that could improve outcome and make use of cell-of-origin research. This type of research for DLBCL has now been in progress for nearly 15 years, but has not yet been used by clinicians to actually change treatment. Alizadeh and colleagues described how DLBCL tumours could be divided into two types by gene expression profiling on the basis of their cells of origin: germinal centre B-cell-like (GCB) and activated B-cell-like (ie, non-GCB). The patients with activated B-cell-like DLBCL had a worse prognosis than did those with GCB disease. Attempts to reproduce the results of the gene expression profiling by immunohistochemistry techniques have been somewhat successful, and the Hans algorithm on formalin-fixed paraffin-embedded tissue has been used in clinical practice. Scott and colleagues showed that new gene expression profiling techniques can be used on formalin-fixed paraffin-embedded tissue to allow rapid reporting of results. Identification of the cell of origin is then possible in a timely fashion so as to be useful for randomisation in clinical trials and routine clinical practice.