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Prognostic Significance of BACH2 Expression in Diffuse Large B-Cell Lymphoma: A Study of the Osaka Lymphoma Study Group

From the Departments of Pathology, Hematology and Oncology, and Functional Diagnostic Science, Osaka University Graduate School of Medicine; 1st Department of Internal Medicine, Kansai Medical University; Department of Clinical Hematology and Clinical Diagnostics, Osaka City University; Department of Hematology, Kinki University School of Medicine; Department of Clinical Laboratory, Osaka Minami Medical Center; Department of Hematology, Sakai Municipal Hospital, Osaka; and Department of Biomedical Chemistry, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan

Address reprint requests to Katsuyuki Aozasa, MD, Department of Pathology (C3), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; e-mail: aozasa{at}molpath.med.osaka-u.ac.jp

PURPOSE: BACH2, a B-cell–specific transcription repressor, is abundantly expressed in lymphocytes of B-cell lineage as well as B-cell lymphoma cell lines. BACH2 possesses an inhibitory effect on proliferation of Raji cell lines derived from Burkitt's lymphoma. In this study, the prognostic significance of BACH2 expression was examined in diffuse large B-cell lymphoma (DLBCL).

PATIENTS AND METHODS: BACH2 expression was immunohistochemically examined on the paraffin-embedded sections obtained by biopsy from 108 patients (62 males and 46 females; age range, 23 to 85 years) with DLBCL. Staining intensity in the cytoplasm of the tumor cells was categorized as equal to or stronger (level 1) or weaker (level 2) than that in the endothelial cells in the same specimens.

RESULTS: Level 1 and 2 expression of BACH2 was found in 32.4% and 67.6% of patients, respectively. Patients with level 1 expression showed significantly better disease-free and overall survival rate than those with level 2 expression (both P < .05). Multivariate analysis revealed BACH2 expression level together with performance status, elevated serum level of lactate dehydrogenase, and treatment response to be independent factors for prognosis of the patients.

CONCLUSION: BACH2 expression level is a useful marker to predict disease-free and overall survival of patients with DLBCL.

Supported by Grants No. 15406013 and 16390105 from the Ministry of Education, Science, Culture and Sports, Japan.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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