Loss of MHC class II gene and protein expression in diffuse large B-cell lymphoma is related to decreased tumor immunosurveillance and poor patient survival regardless of other prognostic factors: a follow-up study from the Leukemia and Lymphoma Molecular Profiling Project

Blood. 2004 Jun 1;103(11):4251-8. doi: 10.1182/blood-2003-07-2365. Epub 2004 Feb 19.

Abstract

The Leukemia and Lymphoma Molecular Profiling Project recently published results from DNA microarray analyses of 240 diffuse large B-cell lymphomas (DLBCLs). Four gene expression "signatures" were identified as correlated with patient outcome, including the major histocompatibility complex (MHC) class II genes (eg, HLA-DRA) which correlated with better survival. We further analyzed the effects of HLA-DRA on survival and correlated gene expression with protein status and tumor-infiltrating lymphocytes. The 5-year overall survival was 24% in the lowest 10% of HLA-DRA expression, 37% in the 10% to 25% group, 50% in the 25% to 50% group, and 55% for patients in the highest 50%. Further analysis demonstrated that the hazard ratio of death was a nonlinear function of HLA-DRA expression. Adjustment for the International Prognostic Index did not alter the impact of HLA-DRA on survival. Other MHC class II genes were found to predict survival similarly. Microarray HLA-DRA expression correlated with the presence or absence of human leukocyte antigen-DR (HLA-DR) protein in 20 of 22 cases assessed. Fewer tumor-infiltrating CD8(+) T cells were detected in MHC class II-negative cases compared with positive cases (2.8% versus 11.0%; P =.001), supporting the hypothesis that loss of tumor immunosurveillance has a devastating effect on patient outcome in DLBCL.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Follow-Up Studies
  • HLA-DR Antigens / genetics
  • Histocompatibility Antigens Class II / genetics*
  • Humans
  • Immunologic Surveillance
  • Lymphoma, B-Cell / genetics*
  • Lymphoma, B-Cell / mortality*
  • Oligonucleotide Array Sequence Analysis
  • Prognosis
  • Survival Analysis

Substances

  • HLA-DR Antigens
  • Histocompatibility Antigens Class II