CD30 Expression in Non-Hodgkin B-Cell Lymphoma
Maria Hintzke, Timothy Fenske, Steven H Kroft, Horatiu Olteanu, Alexandra M Harrington. Medical College of Wisconsin, Milwaukee, WI
Background: Anti-CD30 therapy, recently approved for use in refractory classical Hodgkin lymphoma (cHL) and anaplastic large cell lymphomas (ALCL), has shown response rates of 75-86% and complete remission rates of 34-53%. By definition, CD30 expression is present in cHL and ALCL, but its expression in B-cell non-Hodgkin lymphomas (NHLs) has not been well characterized. Given the potential therapeutic implications, we sought to analyze a large cohort of NHLs for CD30 expression.
Design: Diagnostic tissue cases of diffuse large B cell lymphoma (DLBCL) and limited cases of follicular (FL), mantle cell (MCL), and Burkitt lymphomas (BL) were collected. All diagnoses were made according to 2008 WHO classification. CD30 staining (clone Ber-H2, Dako Cat # IS602, FLEX Ready to Use) was performed on formalin-fixed, paraffin-embedded tissue; expression in any tumor cells was defined as positive. Marrows (BM) were excluded. Expression of CD5, CD10, CD20, and EBER were recorded if available. Charts were reviewed for clinical data.
Results: Biopsies from 146 DLBCLs (64F:82M, 18-82 yrs, median 63), 10 FLs (6F:4M, 30-89yrs), 7 MCLs (2F:5M, 56-71yrs), and 8 BLs (4F:4M, 27-58yrs) were collected. DLBCL biopsy sites included: lymph nodes (33), soft tissue (25), bone (17), retroperitoneum (5), gastrointestinal (15), brain (12), other (39). CD30 expression was positive in 63/146 (43%; 31F: 32M; 18-86 yrs, median 61) DLBCLs and 1 case of FL and negative in 83/146 DLBCLs (57%; 33F:50M; 18-89 yrs, median 66); no cases of MCL or BL showed CD30 expression. BM and blood involvement were present in 13/53 (25%) and 3/51 (5.9%) CD30(-) DLBCLs vs. 5/39 (13%; p=0.19) and 0% (p=0.26) in CD30(+) DLBCLs, respectively. Advanced clinical stage was observed in 56% CD30(-) and 53% CD30(+) DLBCLs (p=1.0). Elevated LDHs were seen in 61% CD30(-) and 53% CD30(+) DLBCLs (p=0.45). 8/15 CD30(+) DLBCLs were EBER(+); all CD30(-) DLBCLs tested (n=20) were EBER(-) (p=0.003). CD5 and CD10 expression were (+) in 7/24 (29%) and 9/26 (35%) of CD30(+) DLBCLs and 5/32 (16%; p=0.41) and 14/36 (39%; p=0.26) CD30(-) DLBCLs, respectively. The t(14;18) was present in 3/22 (14%) CD30(+) DLBCLs and 2/28 (7%) CD30(-) DLBCLs. 1 CD30(+) DLBCL was CD20(-); all remaining DLBCLs were CD20(+). There was no statistically significant association between CD30 expression and tissue site, age, or sex.
Conclusions: Approximately 40% of DLBCLs are CD30(+), rendering these patients potential candidates for anti-CD30 therapy. CD30 expression was largely absent in other NHLs. CD30(+) DLBCLs were more likely to be EBER(+), though no association with other established prognostic indicators was identified.
Tuesday, March 5, 2013 1:00 PM
Poster Session IV # 270, Tuesday Afternoon