Ki-67 expression as a prognostic factor in diffuse large B-cell lymphoma patients treated with rituximab plus CHOP

Dok Hyun Yoon, Dae Ro Choi, Heui June Ahn, Shin Kim, Dae Ho Lee, Sang We Kim, Bong Hee Park, Sun Och Yoon, Jooryung Huh, Sang Wook Lee, Cheolwon Suh

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Abstract

Background: Assessment of tumor cell proliferation based on Ki-67 expression yielded conflicting prognostic predictions of patients with diffuse large B-cell lymphoma (DLBCL). The introduction of rituximab to the DLBCL treatment regime has led to alterations in the significance of previous prognostic factors. Methods: We analyzed Ki-67 expression and its correlation with prognosis in 144 patients with DLBCL treated with rituximab plus CHOP (R-CHOP) between July 2003 and January 2008. Results: The complete response (CR) rates following R-CHOP administration were not significantly different, based on Ki-67 expression status (P = 0.104). However, higher rates of relapse were observed in the high Ki-67 expression group (Ki-67 ≥ 85%, n = 46) with 25.0%, compared to 10.0% in the low Ki-67 expression group (Ki-67 < 85%, n = 88) (P = 0.040). The 2-yr event-free survival (EFS) rates were 44.3% and 74.1% in the high and low Ki-67 expression groups, respectively (P = 0.011). The 2-yr overall survival (OS) rate was 66.4% in the high Ki-67 expression group and 82.2% in the low Ki-67 expression group (P = 0.016). In multivariate analysis, Ki-67 expression was a significant prognostic factor for EFS [hazard ratio (HR) = 2.909; 95% confidence interval (CI) 1.261-6.708; P = 0.012]. Ki-67 was associated with OS but with borderline significance (HR = 2.876; 95% CI, 0.972-8.508; P = 0.056). Conclusion: Elevated Ki-67 expression seems to be associated with higher relapse after CR and inferior EFS in patients with DLBCL treated with R-CHOP.

Original languageEnglish
Pages (from-to)149-157
Number of pages9
JournalEuropean Journal of Haematology
Volume85
Issue number2
DOIs
Publication statusPublished - 2010 Aug 1

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Lymphoma, Large B-Cell, Diffuse
Disease-Free Survival
Survival Rate
Confidence Intervals
Recurrence
Multivariate Analysis
Cell Proliferation
Survival
Rituximab
Neoplasms
Therapeutics

All Science Journal Classification (ASJC) codes

  • Hematology

Cite this

Yoon, Dok Hyun ; Choi, Dae Ro ; Ahn, Heui June ; Kim, Shin ; Lee, Dae Ho ; Kim, Sang We ; Park, Bong Hee ; Yoon, Sun Och ; Huh, Jooryung ; Lee, Sang Wook ; Suh, Cheolwon. / Ki-67 expression as a prognostic factor in diffuse large B-cell lymphoma patients treated with rituximab plus CHOP. In: European Journal of Haematology. 2010 ; Vol. 85, No. 2. pp. 149-157.
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title = "Ki-67 expression as a prognostic factor in diffuse large B-cell lymphoma patients treated with rituximab plus CHOP",
abstract = "Background: Assessment of tumor cell proliferation based on Ki-67 expression yielded conflicting prognostic predictions of patients with diffuse large B-cell lymphoma (DLBCL). The introduction of rituximab to the DLBCL treatment regime has led to alterations in the significance of previous prognostic factors. Methods: We analyzed Ki-67 expression and its correlation with prognosis in 144 patients with DLBCL treated with rituximab plus CHOP (R-CHOP) between July 2003 and January 2008. Results: The complete response (CR) rates following R-CHOP administration were not significantly different, based on Ki-67 expression status (P = 0.104). However, higher rates of relapse were observed in the high Ki-67 expression group (Ki-67 ≥ 85{\%}, n = 46) with 25.0{\%}, compared to 10.0{\%} in the low Ki-67 expression group (Ki-67 < 85{\%}, n = 88) (P = 0.040). The 2-yr event-free survival (EFS) rates were 44.3{\%} and 74.1{\%} in the high and low Ki-67 expression groups, respectively (P = 0.011). The 2-yr overall survival (OS) rate was 66.4{\%} in the high Ki-67 expression group and 82.2{\%} in the low Ki-67 expression group (P = 0.016). In multivariate analysis, Ki-67 expression was a significant prognostic factor for EFS [hazard ratio (HR) = 2.909; 95{\%} confidence interval (CI) 1.261-6.708; P = 0.012]. Ki-67 was associated with OS but with borderline significance (HR = 2.876; 95{\%} CI, 0.972-8.508; P = 0.056). Conclusion: Elevated Ki-67 expression seems to be associated with higher relapse after CR and inferior EFS in patients with DLBCL treated with R-CHOP.",
author = "Yoon, {Dok Hyun} and Choi, {Dae Ro} and Ahn, {Heui June} and Shin Kim and Lee, {Dae Ho} and Kim, {Sang We} and Park, {Bong Hee} and Yoon, {Sun Och} and Jooryung Huh and Lee, {Sang Wook} and Cheolwon Suh",
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Ki-67 expression as a prognostic factor in diffuse large B-cell lymphoma patients treated with rituximab plus CHOP. / Yoon, Dok Hyun; Choi, Dae Ro; Ahn, Heui June; Kim, Shin; Lee, Dae Ho; Kim, Sang We; Park, Bong Hee; Yoon, Sun Och; Huh, Jooryung; Lee, Sang Wook; Suh, Cheolwon.

In: European Journal of Haematology, Vol. 85, No. 2, 01.08.2010, p. 149-157.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Ki-67 expression as a prognostic factor in diffuse large B-cell lymphoma patients treated with rituximab plus CHOP

AU - Yoon, Dok Hyun

AU - Choi, Dae Ro

AU - Ahn, Heui June

AU - Kim, Shin

AU - Lee, Dae Ho

AU - Kim, Sang We

AU - Park, Bong Hee

AU - Yoon, Sun Och

AU - Huh, Jooryung

AU - Lee, Sang Wook

AU - Suh, Cheolwon

PY - 2010/8/1

Y1 - 2010/8/1

N2 - Background: Assessment of tumor cell proliferation based on Ki-67 expression yielded conflicting prognostic predictions of patients with diffuse large B-cell lymphoma (DLBCL). The introduction of rituximab to the DLBCL treatment regime has led to alterations in the significance of previous prognostic factors. Methods: We analyzed Ki-67 expression and its correlation with prognosis in 144 patients with DLBCL treated with rituximab plus CHOP (R-CHOP) between July 2003 and January 2008. Results: The complete response (CR) rates following R-CHOP administration were not significantly different, based on Ki-67 expression status (P = 0.104). However, higher rates of relapse were observed in the high Ki-67 expression group (Ki-67 ≥ 85%, n = 46) with 25.0%, compared to 10.0% in the low Ki-67 expression group (Ki-67 < 85%, n = 88) (P = 0.040). The 2-yr event-free survival (EFS) rates were 44.3% and 74.1% in the high and low Ki-67 expression groups, respectively (P = 0.011). The 2-yr overall survival (OS) rate was 66.4% in the high Ki-67 expression group and 82.2% in the low Ki-67 expression group (P = 0.016). In multivariate analysis, Ki-67 expression was a significant prognostic factor for EFS [hazard ratio (HR) = 2.909; 95% confidence interval (CI) 1.261-6.708; P = 0.012]. Ki-67 was associated with OS but with borderline significance (HR = 2.876; 95% CI, 0.972-8.508; P = 0.056). Conclusion: Elevated Ki-67 expression seems to be associated with higher relapse after CR and inferior EFS in patients with DLBCL treated with R-CHOP.

AB - Background: Assessment of tumor cell proliferation based on Ki-67 expression yielded conflicting prognostic predictions of patients with diffuse large B-cell lymphoma (DLBCL). The introduction of rituximab to the DLBCL treatment regime has led to alterations in the significance of previous prognostic factors. Methods: We analyzed Ki-67 expression and its correlation with prognosis in 144 patients with DLBCL treated with rituximab plus CHOP (R-CHOP) between July 2003 and January 2008. Results: The complete response (CR) rates following R-CHOP administration were not significantly different, based on Ki-67 expression status (P = 0.104). However, higher rates of relapse were observed in the high Ki-67 expression group (Ki-67 ≥ 85%, n = 46) with 25.0%, compared to 10.0% in the low Ki-67 expression group (Ki-67 < 85%, n = 88) (P = 0.040). The 2-yr event-free survival (EFS) rates were 44.3% and 74.1% in the high and low Ki-67 expression groups, respectively (P = 0.011). The 2-yr overall survival (OS) rate was 66.4% in the high Ki-67 expression group and 82.2% in the low Ki-67 expression group (P = 0.016). In multivariate analysis, Ki-67 expression was a significant prognostic factor for EFS [hazard ratio (HR) = 2.909; 95% confidence interval (CI) 1.261-6.708; P = 0.012]. Ki-67 was associated with OS but with borderline significance (HR = 2.876; 95% CI, 0.972-8.508; P = 0.056). Conclusion: Elevated Ki-67 expression seems to be associated with higher relapse after CR and inferior EFS in patients with DLBCL treated with R-CHOP.

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