マルヤマ　タカシ   MARUYAMA Takashi   丸山　隆志    所属   医学部 医学科（東京女子医科大学病院）    職種   非常勤講師
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	Prognostic value of immunohistochemical profile and response to high-dose methotrexate therapy in primary CNS lymphoma
掲載誌名	正式名：Journal of neuro-oncology 略　 称：J Neurooncol ISSNコード：0167594X
巻・号・頁	98(3),pp.341-348
著者・共著者	MOMOTA Hiroyuki†, NARITA Yoshitaka, MAESHIMA Akiko.M, MIYAKITA Yasuji, SHINOMIYA Aya, MARUYAMA Takashi, MURAGAKI Yoshihiro
発行年月	2010/07
概要	Several biomarkers have been identified as prognostic factors in primary central nervous system lymphoma (PCNSL). However, the correlation between the histogenetic origin of PCNSL and the response to therapy is still unclear. To elucidate the utility of immunophenotypic markers in predicting clinical outcomes, we investigated 27 immunocompetent patients with PCNSL treated with high-dose methotrexate therapy. Of the 27 patients, 25 received whole-brain radiotherapy after high-dose methotrexate. Immunostaining for CD5, CD10, BCL-6, and MUM-1 was used to determine the immunophenotypic profile of diffuse large B-cell lymphoma of PCNSL. We then evaluated whether immunophenotypic markers were associated with the response to therapy or patients'survival. The response to induction high-dose methotrexate therapy was determined by magnetic resonance imaging after three courses of i.v. high-dose methotrexate. We categorized B-cell lymphomas into three known subtypes: germinal center B-cell (GCB), activated-GCB, and post-GCB subtypes according to immunohistochemical profile. All the BCL-6-positive samples were co-positive for MUM-1 and therefore classified into activated-GCB subtype. BCL-6 expression in this study was associated with poor progression-free survival (P = 0.038). No immunophenotypic markers or subtypes had a significant effect on the response to high-dose methotrexate therapy. However, the response itself was a significant predictor for both progression-free survival (P<0.001) and overall survival (P = 0.003). Further investigation is needed to assess BCL-6 as a potential prognostic factor in PCNSL.
DOI	10.1007/s11060-009-0078-z
文献番号	20012911