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Immunohistochemical CD20-negative change in B-cell non-Hodgkin lymphomas after rituximab-containing therapy.
- Source :
-
Annals of hematology [Ann Hematol] 2020 Sep; Vol. 99 (9), pp. 2141-2148. Date of Electronic Publication: 2020 May 26. - Publication Year :
- 2020
-
Abstract
- CD20 <superscript>-</superscript> change after rituximab-containing therapy is considered one of the main reasons of rituximab resistance of B-cell non-Hodgkin lymphomas (B-NHLs). However, the clinicopathological characteristics of B-NHL with CD20 <superscript>-</superscript> change are not entirely understood. In this study, 252 B-NHL patients who were CD20 <superscript>+</superscript> at initial diagnosis, whose diseases relapsed or were refractory after rituximab-containing therapy, and who were re-biopsied between 2000 and 2018, were included. The median number of rituximab administration was 11 (range, 1-48). Completely negative (cCD20 <superscript>-</superscript> ) and partially negative (pCD20 <superscript>-</superscript> ) change of CD20 was observed in 49 (20%) and 16 (6%) cases, respectively. Among cCD20 <superscript>-</superscript> and pCD20 <superscript>-</superscript> cases, 74% and 62% of the cases changed to CD20 <superscript>-</superscript> at the second relapse or later, respectively. Overall survival was significantly shorter in cCD20 <superscript>-</superscript> follicular lymphoma (FL) cases than in CD20 <superscript>+</superscript> FL cases. Seven histopathological patterns, such as CD20 <superscript>-</superscript> change without histological change, histological transformation (HT) to CD20 <superscript>-</superscript> diffuse large B-cell lymphoma, and proliferation of plasmablastic/plasmacytoid tumor cells, were associated with CD20 <superscript>-</superscript> change. HT occurred more frequently in FLs with CD20 <superscript>-</superscript> change than in FLs continuously expressing CD20 (P < 0.0001), regardless of the timing of HT. Nine out of 25 cases (36%) showed regain or heterogeneous regain of CD20 expression. In conclusion, 20% and 6% of the 252 B-NHL cases show cCD20 <superscript>-</superscript> and pCD20 <superscript>-</superscript> changes with 7 histological patterns after rituximab-containing therapy. Because changes in morphology and CD20 expression after rituximab-containing therapy vary, and recovery of CD20 expression is not rare, careful follow-up and re-biopsy in B-NHL patients are recommended.
- Subjects :
- Adult
Aged
Aged, 80 and over
Antigens, CD20 chemistry
Cohort Studies
Female
Humans
Lymphoma, B-Cell diagnosis
Male
Middle Aged
Young Adult
Antigens, CD20 immunology
Antineoplastic Agents, Immunological therapeutic use
Lymphoma, B-Cell drug therapy
Lymphoma, B-Cell immunology
Rituximab therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1432-0584
- Volume :
- 99
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Annals of hematology
- Publication Type :
- Academic Journal
- Accession number :
- 32451711
- Full Text :
- https://doi.org/10.1007/s00277-019-03853-1