Assessment of CD37 B-cell antigen and cell of origin significantly improves risk prediction in diffuse large B-cell lymphoma
BLOOD
Authors: Xu-Monette, Zijun Y.; Li, Ling; Byrd, John C.; Jabbar, Kausar J.; Manyam, Ganiraju C.; de Winde, Charlotte Maria; van den Brand, Michiel; Tzankov, Alexandar; Visco, Carlo; Wang, Jing; Dybkaer, Karen; Chiu, April; Orazi, Attilio; Zu, Youli; Bhagat, Govind; Richards, Kristy L.; Hsi, Eric D.; Choi, William W. L.; Huh, Jooryung; Ponzoni, Maurilio; Ferreri, Andres J. M.; Moller, Michael B.; Parsons, Ben M.; Winter, Jane N.; Wang, Michael; Hagemeister, Frederick B.; Piris, Miguel A.; van Krieken, J. Han; Medeiros, L. Jeffrey; Li, Yong; van Spriel, Annemiek B.; Young, Ken H.
Abstract
CD37 (tetraspanin TSPAN26) is a B-cell surface antigen widely expressed on mature B cells. CD37 is involved in immune regulation and tumor suppression but its function has not been fully elucidated. We assessed CD37 expression in de novo diffuse large B-cell lymphoma (DLBCL), and investigated its clinical and biologic significance in 773 patients treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and 231 patients treated with CHOP. We found that CD37 loss (CD37(-)) in similar to 60% of DLBCL patients showed significantly decreased survival after R-CHOP treatment, independent of the International Prognostic Index (IPI), germinal center B-cell-like (GCB)/activated B-cell-like (ABC) cell of origin, nodal/extranodal primary origin, and the prognostic factors associated with CD37(-), including TP53 mutation, NF-kappa B-high, Myc(high), phosphorylated STAT3(high), survivin(high), p63(-), and BCL6 translocation. CD37 positivity predicted superior survival, abolishing the prognostic impact of high IPI and above biomarkers in GCB-DLBCL but not in ABC-DLBCL. Combining risk scores for CD37(-) status and ABC cell of origin with the IPI, defined as molecularly adjusted IPI for R-CHOP (M-IPI-R), or IPI plus immunohistochemistry (IHC; IPI+IHC) for CD37, Myc, and Bcl-2, significantly improved risk prediction over IPI alone. Gene expression profiling suggested that decreased CD20 and increased PD-1 levels in CD37(-) DLBCL, ICOSLG upregulation in CD37(+) GCB-DLBCL, and CD37 functions during R-CHOP treatment underlie the pivotal role of CD37 status in clinical outcomes. In conclusion, CD37 is a critical determinant of R-CHOP outcome in DLBCL especially in GCB-DLBCL, representing its importance for optimal rituximab action and sustained immune responses. The combined molecular and clinical prognostic indices, M-IPI-R and IPI+IHC, have remarkable predictive values in R-CHOP-treated DLBCL.
Comparative genetic analysis of inflammatory bowel disease and type 1 diabetes implicates multiple loci with opposite effects
HUMAN MOLECULAR GENETICS
Authors: Wang, Kai; Baldassano, Robert; Zhang, Haitao; Qu, Hui-Qi; Imielinski, Marcin; Kugathasan, Subra; Annese, Vito; Dubinsky, Marla; Rotter, Jerome I.; Russell, Richard K.; Bradfield, Jonathan P.; Sleiman, Patrick M. A.; Glessner, Joseph T.; Walters, Thomas; Hou, Cuiping; Kim, Cecilia; Frackelton, Edward C.; Garris, Maria; Doran, James; Romano, Claudio; Catassi, Carlo; Van Limbergen, Johan; Guthery, Stephen L.; Denson, Lee; Piccoli, David; Silverberg, Mark S.; Stanley, Charles A.; Monos, Dimitri; Wilson, David C.; Griffiths, Anne; Grant, Struan F. A.; Satsangi, Jack; Polychronakos, Constantin; Hakonarson, Hakon
Abstract
Inflammatory bowel disease, including Crohn's disease (CD) and ulcerative colitis (UC), and type 1 diabetes (T1D) are autoimmune diseases that may share common susceptibility pathways. We examined known susceptibility loci for these diseases in a cohort of 1689 CD cases, 777 UC cases, 989 T1D cases and 6197 shared control subjects of European ancestry, who were genotyped by the Illumina HumanHap550 SNP arrays. We identified multiple previously unreported or unconfirmed disease associations, including known CD loci (ICOSLG and TNFSF15) and T1D loci (TNFAIP3) that confer UC risk, known UC loci (HERC2 and IL26) that confer T1D risk and known UC loci (IL10 and CCNY) that confer CD risk. Additionally, we show that T1D risk alleles residing at the PTPN22, IL27, IL18RAP and IL10 loci protect against CD. Furthermore, the strongest risk alleles for T1D within the major histocompatibility complex (MHC) confer strong protection against CD and UC; however, given the multi-allelic nature of the MHC haplotypes, sequencing of the MHC locus will be required to interpret this observation. These results extend our current knowledge on genetic variants that predispose to autoimmunity, and suggest that many loci involved in autoimmunity may be under a balancing selection due to antagonistic pleiotropic effect. Our analysis implies that variants with opposite effects on different diseases may facilitate the maintenance of common susceptibility alleles in human populations, making autoimmune diseases especially amenable to genetic dissection by genome-wide association studies.