|
About
Lymphoma >
Prognostic Indicators
Last update:
08/06/2012
|
TOPICS
Prognostic
Indicators & Biomarkers
IPI |
FLIPI
/ FLIPI-2
| MIPI |
CLL/SLL
Indications of
Need-to-Treat indolent lymphomas:
GELF /
NCCN
| Specific Biomarkers
TOPIC
SEARCH
ASCO.org
|
ASH
|
Medscape |
PubMed
"Because most of the
prognostic studies are based on a retrospective analysis of historical
data, they must be interpreted with caution at a time when treatment
modalities are changing."
herkules.oul
|
Prognostic
Indicators
TOPIC
SEARCH microenvironment AND prognosis
PubMed
Related Topics:
Return to top
|
NOTABLE QUOTE ON LIMITATIONS OF
PROGNOSTIC MARKERS:
"What is really the most important for people to
remember is that prognostic markers only tell you which
curve you are on, they do not tell you where you are on
the curve.
[For CLL] nothing is more helpful than the pace of your
disease. If your WBC is rising slowly, hemoglobin and
platelets stable, lymphadenopathy and spleen size
stable, then you are behaving in a very indolent manner.
This means that the CLL is progressing very slowly and,
by and large, will continue to do so for future."
~ Rick Furman, MD
Question: I have been diagnosed with Lymphoma Stage 4. Do you have
any statistics as to the survival rate of patients with this
diagnosis?
Prognosis is a case-based guess - specific to your age,
lymphoma type, the variable clinical behavior even within specific
subtypes (follicular, MALT, MCL ...) secondary conditions, general health, etc.
- answering the question
of a patient: "What's my prognosis, doctor?"
Median survival is the result of arithmetic to find the middle point ...
done on a large group - answering the question of researchers: "Are we making progress overall?"
So if your doctor gives you the median survival when you ask how long you've
got ... he's not using the terminology correctly. And providing a prognosis
would also be a guess .. a poor guess at that for follicular lymphoma
(as an example), because of the variable behavior of this condition.
Survival of lymphoma varies also by cell type ... and there are about 30
types of lymphoma. Some types of lymphoma can be cured.
Other cell types can be managed very well, like a chronic
disease.
Statistics cannot predict what will happen
to you or a loved one. Each patient and case is unique, and treatment
outcomes can vary from one person to another. Indeed, not even
your doctor can tell you for sure what will happen.
The term '5 year survival' is used often. It relates to the proportion
of people in research studies who were still alive 5 years after
diagnosis. However, importantly, patients who live 6, 10, or 30 years after
diagnosis are also in this group.
Therefore "5 year survival" statistics do
not mean
you have five years to live.
Survival expectations increase
for those who have survived beyond 1, 2, 3, or 4 years. For
example, 8 year survival might be the average for a given type of
lymphoma, but for patients who have already survived five years, the
average survival could be well beyond the average survival at
diagnosis. (Similarly, a higher percentage of Marathon runners who
reach the 10 mile mark will complete the race, compared to all that
have started it.)
Furthermore, Overall Survival
(OS) is calculated
based on death from any cause, and is strongly influenced by the
average age at diagnosis. For follicular lymphomas, a median OS of 8
to 10 years is often cited and the average age at diagnosis is about
65 years. However, a recent report from Stanford, based on patients
with a median age of 49, the median (average) OS was 18 years.
It's worth considering that OS measures time to death from *any* cause. Ask yourself: What is
the median OS if you are 65 years old and have no lymphoma? 14 years? 8
years?
Factors that influence, but do not predict, the survival for
patients with lymphoma include:
.gif) |
the cell
type, |
|
|
the grade
(a good percentage of pts with aggressive NHL can be cured, and
pts with indolent NHL can live well and long with the disease) |
|
|
the stage of the
disease (almost everyone is diagnosed with stage 4), |
|
|
the age and
performance level of the patient, |
|
|
tumor
burden, |
|
|
LDH
levels, |
|
|
number of extranodal
sites (tumors outside the lymph organs). |
|
|
hemoglobin level (< 12
g/dL vs. >/= 12 g/dL), |
|
|
response to initial treatment, and duration of the response;
"Response to treatment is one of the most important prognostic
indicators, particularly in patients with aggressive NHL."
ncbi.nlm.nih.gov |
|
|
genetic characterizations,
including the microenvironment
which are now being explored with advanced testing. |
Resources:
|
|
Expert background: Optimal Use of
Prognostic Factors in NHL asheducationbook.
2006 pdf
The management of non-Hodgkin lymphoma is complicated by wide
heterogeneity within recognized subtypes. Patients with supposedly
similar diagnoses can have remarkably varied clinical
presentations, molecular profiles and clinical outcomes. Reliable
prognostic markers could allow the identification of patient
subsets that may benefit from alternate approaches.
|
|
|
Survival after progression in patients with follicular
lymphoma: analysis of prognostic factors annonc.oxfordjournals.org
In patients with FL, Response Duration (RD) along with performance
status at progression are features that predict
Survival Following Progression. These variables could thus be
useful to select candidates
for experimental treatments.
|
|
|
cFLIP expression correlates with tumour progression and
patient outcome in non-Hodgkin lymphomas of low grade of
malignancy. Br J Haematol. 2006 Mar;132(5):560-70. PMID:
16445828
|
|
|
|
|
|
Ann Arbor Stages of
Non-Hodgkin's Lymphoma Grade
|
|
|
Biologic Prognostic Features in Non-Hodgkin’s Lymphoma and Their Implications, Bertrand Coiffier
PDF | PDF-Help
|
|
|
Bone marrow involvement and survival for low grade NHL?
PubMed
| Related
articles
"Conclusion. The presence of bone marrow infiltration at
diagnosis did not significantly affect the prognosis of LGNHL."
|
|
|
Liver involvement and survival? PMID: 10561315 PubMed
|
|
|
Transformation PAL
|
|
|
What if I'm BCL2 negative? BCL2
Negative
|
Research News
CLL/SLL
|
|
CLL Aggressiveness May Be Predicted By New Biomarker medicalnewstoday.com
They found that high levels of a particular enzyme
PDE7B) in the blood are an indicator that chronic lymphocytic
leukemia (CLL) - the most common form of adult leukemia - will be
aggressive and in need of immediate treatment.
|
Diffuse Large Cell Lymphoma:
TOPIC SEARCH
prognostic markers PubMed
|
|
Low absolute lymphocyte count is a poor prognostic factor in diffuse-large-B-cell-lymphoma.
Leuk Lymphoma. 2008 Sep;49(9):1745-51. PMID: 18798109
|
|
|
A redox signature score identifies diffuse large B-cell lymphoma patients with a poor
prognosis.Blood. 2005 Aug 4; PMID: 16081686
| Related
articles
|
Follicular lymphoma:
TOPIC SEARCH microenvironment WEB
|
|
Gene-Expression and Immunohistochemical Study of Specific
T-Cell Subsets and Accessory Cell Types in the Transformation and
Prognosis of Follicular Lymphoma. J Clin Oncol. 2007 Jan 2; PMID:
17200149 | Related
articles
|
|
|
Overexpression of SOCS3 is associated with decreased
survival in a cohort of patients with de novo follicular lymphoma.
Br J Haematol. 2006 Aug 24; PMID:
16939500
OCS3-positive FL patients had a median OS of 10 years compared
with 22 years in
SOCS3-negative patients (P = 0.001, log rank test).
|
|
|
Immunohistochemical analysis of the antiapoptotic Mcl-1 and
Bcl-2 proteins in follicular lymphoma. Br J Haematol. 2006
Mar;132(6):743-6. PMID:
16487175
|
|
|
Molecular pathogenesis of follicular lymphoma: a cross talk
of genetic and immunologic factors. J Clin Oncol. 2005 Sep
10;23(26):6358-63. Review. PMID:
16155020
|
|
|
Increased Vascularization Predicts Favorable Outcome in
Follicular Lymphoma 2005 aacrjournals.org |
full
text
|
|
|
Predicting Cancer Patient Survival with Gene Expression Data
DOI: 10.1371/journal.pbio.0020118 - full text plosbiology.org
|
|
|
[2266] Follicular Lymphoma: Design of a
Protein-Based Survival Predictor Using Tissue-Microarrays (TMA).
Session Type: Poster Session 479-II ASH
2004
|
|
|
High expression of cyclin B1 predicts a favorable outcome of
patients with follicular lymphoma. Blood. 2004 Dec 2; PMID:
15576476
|
|
|
Bone marrow histological patterns can predict survival of
patients with grade 1 or 2 follicular lymphoma: a study from the
Groupe d'Etude des Lymphomes Folliculaires.
Br J Haematol. 2004 Aug;126(3):364-71. PMID:
15257708
|
|
|
Follicular lymphoma international prognostic index.
Blood. 2004 May 4 [Epub ahead of print] PMID:
15126323
|
|
|
Prognostic indicator:
Expression of bcl-6 and CD10 protein is associated with longer
overall survival and time to treatment failure in follicular
lymphoma. Am J Clin Pathol. 2004 Jan;121(1):34-42. PMID:
14750238 | Related
articles
|
|
|
Prognosis of
follicular lymphoma: a predictive model based on a retrospective
analysis of 987 cases. Intergruppo Italiano Linfomi. Blood. 2000
Feb 1;95(3):783-9 full
text | Related
abstracts
|
|
|
Survival in young patients (less than 40 years) with
follicular lymphoma: a population based study by the Scotland and
Newcastle Lymphoma Group. Leuk Lymphoma. 2004 Jun;45(6):1149-57. PMID:
15359994
|
|
|
Survival after progression in patients with follicular
lymphoma: analysis of prognostic factors. Ann Oncol. 2002
Apr;13(4):523-30. PMID:
12056701 | Related
articles
|
|
|
Serum CA 125 as a
prognostic factor in non-Hodgkin's lymphoma.
Leuk Lymphoma. 2003 Oct;44(10):1733-8. PMID:
14692526 | Related
articles
|
|
|
High serum
interleukin-6 levels correlate with a shorter failure-free
survival in indolent lymphoma. Leuk Lymphoma. 1998
Aug;30(5-6):563-71. PMID:
9711918 | Related
articles
|
|
|
Increased serum
levels of interleukin-9 correlate to negative prognostic factors
in Hodgkin's lymphoma. Leukemia. 2003 Oct 9 [Epub ahead of print] PMID:
14562126 | Related
articles
|
|
|
Presentation serum
selenium predicts for overall survival, dose delivery, and first
treatment response in aggressive non-Hodgkin's lymphoma. J Clin
Oncol. 2003 Jun 15;21(12):2335-41. PMID: 12805335
| Related
articles
|
|
|
Tumor load in patients
with follicular lymphoma post stem cell transplantation may
correlate with clinical course. Bone Marrow Transplant. 2003
Aug;32(3):287-291. PMID: 12858200 PubMed
|
|
|
Low-grade stage III-IV follicular lymphoma: multivariate
analysis of prognostic factors in 484 patients--a study of the
groupe d'Etude des lymphomes de l'Adulte.
J Clin Oncol. 1999 Aug;17(8):2499-505. PMID: 10561315 PubMed
|
|
|
Clinicopathologic
correlations of genomic gains and losses in follicular lymphoma.
J Clin Oncol. 2002 Dec 1;20(23):4523-30. PMID: 12454108 PubMed
|
|
|
A significant diffuse component predicts for inferior survival
in grade 3 follicular lymphoma, but cytological subtypes do not
predict survival. Blood. 2002 Nov 7 PMID: 12424193 PubMed
|
|
|
Assessment of prognostic factors in follicular lymphoma
patients.
Int J Hematol. 2001 Apr;73(3):363-8. PMID: 11345204 PubMed
|
|
|
Pregnancy in the patient with lymphoma does not predict an
adverse prognosis Year: 2002 Abstract No: 1141
|
|
|
Prognosis of follicular lymphoma: a predictive model based on
a retrospective analysis of 987 cases. Intergruppo Italiano
Linfomi. Blood. 2000 Feb 1;95(3):783-9. PMID: 10648386 PubMed
|
|
|
Prognostic significance of Ki-67 nuclear proliferative
antigen, bcl-2 protein, and p53 expression in follicular and
diffuse large B-cell lymphoma. Med Oncol. 2001;18(1):15-22. PMID:
11778965 PubMed
"Prognostic factors for overall survival in the
multivariate analysis were age (p = 0.02) and LDH (p = 0.003).
Time to progression was worse among follicular lymphoma with high
p53 expression than with mild/moderate p53 expression (p =
0.009)."
|
Cutaneous b-cell lymphoma
|
|
Prognostic Factors in Primary Cutaneous B-Cell Lymphoma: The
Italian Study Group for Cutaneous Lymphomas. J Clin Oncol. 2006
Feb 21; PMID:
16492713
|
Hodgkins Lymphoma
|
|
NEW: Better Prognosis
for Patients with Lymphocyte-predominant Hodgkin’s Lymphoma patient.cancerconsultants.com
"In order to better understand characteristics of LPHL
[Lymphocyte-predominant HL], researchers from Germany conducted an
analysis of 8,298 HL patients treated within a German medical
trial to compare patient characteristics and treatment outcomes
among cHL [classical HL) patients and others diagnosed with LPHD .
"
|
|
|
NEW: Prognostic impact of bone involvement in Hodgkin lymphoma.
Neoplasma. 2008;55(2):96-100. PMID: 18237246
... bone involvement is a relatively common finding in HL and is
not an independent adverse prognostic factor. Key words: Hodgkin lymphoma - bone involvement - prognostic factors.
|
|
|
MAL [a gene also expressed in mediastinal (thymic) large
B-cell lymphoma] is expressed in a subset of Hodgkin lymphoma and
identifies a population of patients with poor prognosis. Am J Clin
Pathol. 2006 May;125(5):776-82. PMID:
16707382 | Related
articles
"Expression correlated with nodular sclerosis subtype, and
within this subtype, with grade 2 histology."
|
Marginal Zone/MALT
|
|
Splenic marginal zone lymphoma: a prognostic model for
clinical use.
Blood. 2006 Feb 21; PMID:
16493005
|
T-cell
TOPIC
SEARCH - PubMed
|
|
Marker Expression in Peripheral T-Cell Lymphoma: A Proposed
Clinical-Pathologic Prognostic Score. J Clin Oncol. 2006 Apr 24; PMID:
16636342
|
|
|
Immunophenotypic and molecular features, clinical outcomes, treatments, and prognostic factors associated with subcutaneous panniculitis-like T-cell lymphoma: a systematic analysis of 156 patients reported in the literature.
Cancer. 2004 Sep 15;101(6):1404-13. PMID: 15368328
|
|
International
Prognostic Indexes
|
Prognostic Indexes
IPI and FLIPI
"Because most of the
prognostic studies are based on a retrospective analysis of historical
data, they must be interpreted with caution at a time when treatment
modalities are changing." - herkules.oul
FLIPI
DISCUSSION
(Clinical Implications):
"The FLIPI may be used for selecting treatment in individual
patients. In patients with a good prognosis (0-1 adverse
factor), the 10-year overall survival is 71%. This
indicates that optimal treatment in these patients has to
avoid toxicity and to preserve quality of life.
Involved-field radiation therapy for patients with limited
disease and an initial "no treatment policy," for patients
with disseminated disease may be recommended outside clinical
trials. In contrast, patients with high-risk FL have a
median survival around 5 years. Innovative approaches such as
the combination of CVP (cyclophosphamide, vincristine, prednisone)
or CHOP (CVP plus doxorubicin) and anti-CD20 monoclonal
antibody,32 purine analog-based
regimens,33 and autologous stem cell
transplantation30 followed by vaccine
therapies34 may be studied in this
subgroup. All these approaches have been so far evaluated
in phase 2 studies. The size of the high-risk group (27% of
patients in the sample used for creating this index and 28%
in the sample used for validation) could allow the design
of multicenter randomized trials."
Full
Text - Blood
Return to top
|
When considering prognostic indexes we should bear in
mind that: "Prognostic factors reflect the outcome of very
specific treatments, and as treatment changes, prognostic factors
change.
When you include patients who did not receive uniform therapy,
prognostic factor analysis and the impact on PFS may not be accurate."
~ Dr. Younes.
journals.lww.com/oncology
_____________________________________________
International
Prognostic Index (IPI)
Designed to further clarify lymphoma
staging. The IPI [roughly] predicts the risk of disease recurrence and
overall survival:
|
|
Age over 60 years
|
|
|
Late-stage disease (Stages 3 and 4)
|
|
|
More than one extranodal site
|
|
|
High LDH |
|
|
Poor general health or
performance |
Source:
oncologychannel.com
Calculate your FLIPI qxmd.com
_____________________________________________
Follicular
Lymphoma International
Prognostic Index (FLIPI)
Full
Text - Blood
Our impression is that the main purpose of FLIPI
is to characterize participants in clinical trials so that the results can be compared better across studies ... (as in FLIPI scores were balanced in each arm of the study, or in this study compared to that).
It appears the physicians may sometimes use FLIPI to guide treatment selection and possibly timing of treatment, but FLIPI is not predictive of outcomes in individual cases - or predictive of outcomes with specific therapies.
"FLIPI is recommended In
patients with FL at first relapse/progression, the FLIPI,
along with the presence of bulky disease and B symptoms, are
features that predict Five-year survival from progression (SFP) and
thus could be useful to select candidates for experimental
treatments."
annonc.oxfordjournals.org
Five adverse prognostic factors were selected:
-
age (> 60 vs. </= 60),
-
Ann Arbor stage (III-IV vs. I-II),
-
hemoglobin level (< 12
g/dL vs. >/= 12 g/dL),
-
number of nodal areas (> 4 vs. </= 4),
See
graphic
-
serum LDH level (> normal vs. </= normal).
Three risk groups were defined:
-
Low-risk
(0-1 adverse factor, 36 % of patients,
10-year survival of 70.7 %),
-
Intermediate-risk (2 factors, 37 % of patients,
10-year survival of 51 % and a hazard-ratio of 2.3),
-
Poor-risk (>/= 3 adverse factors, 27 % of patients,
10-year survival of 35.5 % and a hazard-ratio of 4.3).
See discussion in sidebar
"One point is given for each factor present at diagnosis. Patients with zero to one factors are classified as low-risk patients and have 5- and 10-year survivals of 90% and 71%, respectively.
Patients with two factors are classified as intermediate risk and they have 5- and 10-year survivals of 78% and 51%, respectively.
High-risk disease patients have three to five factors and 5- and 10-year survivals of 53% and 36%, respectively. The relative frequencies of the three risk categories are 36%, 37%, and 27%, which is a significant improvement over the IPI distribution in follicular lymphoma."
Source: Follicular Lymphoma: Management Options in the Era of Targeted Therapy
Christopher G. Peterson, MD Brad S. Kahl, MD* ~ Current Treatment Options in Oncology 2005, 6:297–308
_____________________________________________
Evaluating FLIPI-2, the Follicular Lymphoma Prognostic Index
Five adverse prognostic factors predicted
Progression Free Survival, which is a controversial measure of overall
survival (see Discussion below.)
-
age > 60
-
Hemoglobin level < 12
g/dL
-
serum B2M > ULN
-
LoDLIN > 6 cm (The
longest diameter of the largest involved node)
-
Bone Marrow Involvement
|
|
|
|
|
Discussion:
Evaluating FLIPI-2, the New Follicular Lymphoma
Prognostic Index
http://bit.ly/mR3h3I
snip: …. "prognostic factors
reflect the outcome of very specific treatments, and as
treatment changes, prognostic factors change. When you include
patients who did not receive uniform therapy, prognostic factor
analysis and the impact on PFS may not be accurate."
|
_____________________________________________
Mantle
Cell Lymphoma International Prognostic Index (MIPI)
A
new prognostic index (MIPI) for patients with advanced-stage
mantle cell lymphoma
bloodjournal.hematologylibrary.org
Using data of 455 advanced stage MCL patients
treated within 3 clinical trials, we examined the
prognostic relevance of IPI and FLIPI and derived a
new prognostic index (MCL international prognostic index, MIPI)
of overall survival (OS).
According
to the MIPI, patients were classified into
|
|
low
risk (44% of patients, median OS not
reached), |
|
|
intermediate
risk (35%, 51 months), and |
|
|
high
risk groups (21%, 29 months),
|
based on the 4 independent prognostic factors:
|
|
age,
|
|
|
performance
status, |
|
|
lactate
dehydrogenase (LDH), and |
|
|
leukocyte
count. |
|
|
Cell
proliferation (Ki-67) was exploratively analyzed as
an
important biologic marker and showed strong
additional
prognostic relevance.
|
The MIPI is the first prognostic index particularly suited for
MCL patients and may serve as an important tool to
facilitate risk-adapted treatment decisions in
patients with advanced stage MCL.
NEED TO TREAT CRITERIA
_____________________________________________
GELF Criteria
A guide for determining the need to treat
indolent lymphoma
NOTE: This is a general guide. The need to begin
treatment in individual cases can vary.
One or more of
the following
|
|
Involvement of 3 nodal sites, each with a diameter of 3 cm
|
|
|
Any nodal or extranodal tumor mass with a diameter of 7 cm
|
|
|
|
|
|
Splenomegaly (enlarged spleen)
|
|
|
|
|
|
Cytopenias (leukocytes < 1.0 x 10 /L and
or platelets < 100 x 10 /L)
|
|
|
Leukemia (> 5.0 x 10 /L malignant cells)
|
_____________________________________________
NCCN Guidelines:
Indications to treat indolent lymphomas
NOTE: This is a general guide. The need to begin treatment
in individual cases can vary.
|
|
Symptoms
(fatigue, pain, fevers...) |
|
|
Threatened
end-organ function (enlarged node obstructing bowel)
|
|
|
Cytopenia
secondary to lymphoma (low blood counts)
|
|
|
Bulky
disease - according to the GELF criteria: nodal or
extra-nodal
|
|
|
mass (except
spleen) > 7cm in its greater diameter 2
|
|
|
Steady
progression |
|
|
Patient
preference |
|
|
Elevated
serum LDH or B2-microglobulin |
|
|
involvement
of multiple nodal sites
(each with a diameter greater than 3 cm)
2 |
|
|
symptomatic
splenic enlargement 2 |
|
|
compressive
syndrome 2 |
|
|
pleural/peritoneal
effusion 2 |
Sources:
nccn.org/ 1
PRIMA study: 2
http://prima.
gela.org/
|
|
Specific Biomarkers
|
Biomarkers
Under construction
"Indirect" indicates that
increased levels can have other causes besides lymphoma.
Return to top
|
TOPIC
SEARCH microenvironment AND prognosis WEB
| PubMed
NOTABLE QUOTE ON LIMITATIONS OF
PROGNOSTIC MARKERS:
|
"What is really the most important for people to
remember is that prognostic markers only tell you which
curve you are on, they do not tell you where you are on
the curve.
[For CLL] nothing is more helpful than the pace of your
disease. If your WBC is rising slowly, hemoglobin and
platelets stable, lymphadenopathy and spleen size
stable, then you are behaving in a very indolent manner.
This means that the CLL is progressing very slowly and,
by and large, will continue to do so for future."
~ Rick Furman, MD
|
Some
reports on suspected prognostic factors:
|
|
|
|
|
Tumor-associated Antigen Arrays for the
Serological Diagnosis of
Cancer
http://bit.ly/9xqoNy |
|
|
absolute
lymphocyte count at diagnosis
Absolute lymphocyte count predicts overall survival in follicular
lymphomas.
Br J
Haematol. 2006 Sep;134(6):596-601. Epub 2006 Aug 1.
PMID:
16889618
|
|
|
Urinary
albumin excretion [post treatment] is a predictor of response to
treatment and disease progression in low-grade non-Hodgkin's
lymphoma. Leuk Lymphoma. 2004 Mar;45(3):547-51. (Lower is
better.) PMID:
15160917 | Related
articles
|
|
|
Beta2-microglobulin is a
protein found on the surface of many cells, including white blood
cells. (indirect)
|
|
|
Serum
CA125: A Tumor Marker for Monitoring Response to Treatment and
Follow-up in Patients with Non-Hodgkin’s Lymphoma theoncologist.alphamedpress.org
|
|
|
Strong
Expression of FOXP1 Identifies a Distinct Subset of Diffuse Large
B-Cell Lymphoma Patients with Poor Outcome. Blood. 2004 Jul 6 PMID:
15238418
|
|
|
Lactate Dehydrogenase (LDH) is an enzyme that
is expressed at higher levels when lymphocytes are dividing.
(indirect)
|
|
|
Ki-67
- proliferation index (indirect)
-
"Typically,
reactive follicles are characterized by absence of bcl-2
expression and a high Ki-67-defined cell proliferation index,
in contrast to the typical low grade follicular lymphoma, in
which the cells are bcl-2-positive and show a very low
Ki67-defined cell proliferation index." phenopath.com
|
|
|
Diffuse
component
|
|
|
BCL-2 -
PAL
|
|
|
|
|
|
BCL-6
|
|
"Rearrangement of the bcl-6 gene
correlated with a favorable clinical outcome in Diffuse
Large Cell Lymphoma" |
|
|
|
BLyS:
Expression of BLyS and Its Receptors in B-Cell Non-Hodgkin
Lymphoma: Correlation With Disease Activity and Patient Outcome.
Blood. 2004 Jul 13 PMID:
15251985
|
|
|
Prediction
of survival in follicular lymphoma based on molecular features of
tumor-infiltrating immune cells. N Engl J Med. 2004 Nov
18;351(21):2159-69.
PMID:
15548776
|
|
|
Serologic
detection of diffuse large B-cell lymphoma-associated antigens.
Int J Cancer. 2004 Jul 1;110(4):563-9. PMID:
15122589 | abstracts
|
|
|
Immunohistochemical detection of ZAP-70
in 341 cases of non-Hodgkin and Hodgkin lymphoma; May 2004 nature.com
|
|
|
