Originally published as JCO Early Release 10.1200/JCO.2005.02.4786 on January 17 2006

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Prognostic Biomarkers in Diffuse Large B-Cell Lymphoma

From the Department of Medicine, Division of Hematology/Oncology, and Department of Molecular and Cellular Pharmacology, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL

Address reprint requests to Izidore S. Lossos, MD, University of Miami, Sylvester Comprehensive Cancer Center, Division of Hematology-Oncology, Department of Medicine, 1475 NW 12th Ave (D8-4), Miami, FL 33136; e-mail:ilossos{at}med.miami.edu

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin's lymphoma. Although it represents a curable disease, less than half of the patients are cured with conventional chemotherapy. The highly variable outcome reflects a heterogeneous group of tumors, with different genetic abnormalities and response to therapy. The International Prognostic Index (IPI) is useful in predicting the outcome of DLBCL patients. However, patients with identical IPI still exhibit marked variability in survival, suggesting the presence of significant residual heterogeneity within each IPI category. The discovery of specific genetic alterations and the assessment of protein expression led to the identification of multiple novel single molecular markers capable of predicting the outcome of DLBCL patients independently of clinical variables. The recent application of DNA microarrays and tissue array technologies allowed a better understanding of the biology of lymphoma and the development of novel diagnostic tools capable of improving the current models for outcome prediction. However, much confusion exists in the literature regarding the importance of different prognostic biomarkers and their applicability in routine practice. This review summarizes the recent advances in our understanding of prognostic biomarkers in DLBCL and discusses whether this is the right time for biomarkers-guided risk-adjusted therapy.

Supported by Grant No. RO1 CA109335 from the United States Public Health Service, National Institutes of Health.

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

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