CD30 expression in de novo diffuse large B-cell lymphoma: a population-based study from British Columbia

Area of Science:

• Oncology
• Immunology
• Pathology

Background:

• Diffuse large B-cell lymphoma (DLBCL) exhibits variable treatment responses.
• Alternative therapies are needed for patients with poor outcomes after R-CHOP treatment.
• CD30 expression patterns in DLBCL require further elucidation for targeted therapies like brentuximab vedotin.

Purpose of the Study:

• To investigate CD30 (TNFRSF8) expression in de novo DLBCL.
• To determine the prognostic significance of CD30 expression in DLBCL patients treated with R-CHOP.
• To explore the association between CD30 expression, Epstein-Barr virus (EBV) status, and DLBCL subtypes.

Main Methods:

• Analysis of CD30 expression using immunohistochemistry on 385 formalin-fixed paraffin-embedded DLBCL tissue microarrays.
• Evaluation of CD30 positivity in relation to treatment outcomes, including 5-year progression-free survival.
• Assessment of Epstein-Barr virus (EBV) co-occurrence with CD30 expression and DLBCL subtypes (GCB vs. non-GCB).

Main Results:

• CD30-positive tumor cells were identified in 25% (95/385) of DLBCL cases.
• CD30 expression (cut-off >0%) was a significant predictor of superior 5-year progression-free survival in R-CHOP treated germinal centre B-cell-like (GCB) DLBCL (86% vs. 64%, P=0.020).
• Epstein-Barr virus (EBV) was found in 3% of cases, predominantly in non-GCB subtypes and strongly associated with CD30 expression (10/11 cases).

Conclusions:

• CD30 is expressed in a substantial subset of DLBCL.
• CD30 immunohistochemistry can serve as a valuable prognostic marker in R-CHOP treated GCB-DLBCL.
• The strong association of CD30 with EBV-positive non-GCB DLBCL suggests a distinct pathobiology in these cases.