Statin use has negative clinical impact on non-germinal center in patients with diffuse large B cell lymphoma in rituximab era.
- Authors
- Song, Moo Kon; Chung, Joo-Seop; Lee, Gyeong-Won; Cho, Su-Hee; Hong, Junshik; Shin, Dong-Yeop; Shin, Ho-Jin
- Issue Date
- Feb-2015
- Publisher
- PERGAMON-ELSEVIER SCIENCE LTD
- Keywords
- Rituximab; Diffuse large B cell lymphoma; Statin; Germinal center
- Citation
- LEUKEMIA RESEARCH, v.39, no.2, pp.211 - 215
- Indexed
- SCIE
SCOPUS
- Journal Title
- LEUKEMIA RESEARCH
- Volume
- 39
- Number
- 2
- Start Page
- 211
- End Page
- 215
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/157879
- DOI
- 10.1016/j.leukres.2014.12.003
- ISSN
- 0145-2126
- Abstract
- Rituximab improved prognosis in diffuse large B cell lymphoma (DLBCL). However, activity of rituximab may be reduced by conformational change in CD20 by statin-induced cholesterol depletion. Conformation change in CD20 could impair the binding of rituximab and significantly decrease the killing effect of lymphoma cells. R-CHOP therapy could counteract the prognostic gap between GC type and non-GC type. We investigated whether statin use could have different clinical impacts on immunohistochemical DLBCL subtypes in the rituximab era.
We analyzed data from 409 patients with de novo DLBCL who received R-CHOP therapy. During median follow-up time of 38.6 months, 3-year progression-free survival (PFS) and overall survival (OS) in the GC type were similar to those in the non-GC type (PFS, p = 0.125; OS, p = 0.201). Moreover, survivals were comparable between patients with statin therapy and those without the statin therapy (PFS, p = 0.282; OS, p=0.273). We also analyzed whether statin therapy would have clinical significance by immunophenotypes in patients treated with R-CHOP therapy. The non-GC type with statin therapy had inferior PFS and OS compared to other groups (PFS, p = 0.008; OS, p = 0.006). In multivariate analysis, statin therapy had significant negative impacts on survivals of the non-GC type independent of other clinical factors (PFS, hazard ratio/HR: 1.553, 95% CI: 1.058-2.279, p = 0.024; OS, HR= 1.532, 95% CI: 1.041-2.255, p =0.023). Therefore, statin therapy negatively affected the clinical outcome of the non-GC phenotype, but it was beneficial to R-CHOP therapy in DLBCL.
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