Prognostic impact of C-REL expression in diffuse large B-cell lymphoma

Choladda V. Curry, April A. Ewton, Randall J. Olsen, Brent R. Logan, Hector A. Preti, Yao Chang Liu, Sherrie L. Perkins, Chung Che Chang

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Diffuse large B-cell lymphoma (DLBCL) with a germinal center B-cell (GCB) phenotype is believed to confer a better prognosis than DLBCL with an activated B-cell (ABC) phenotype. Previous studies have suggested that nuclear factor-κB (NF-κB) activation plays an important role in the ABC subtype of DLBCL, whereas c-REL amplification is associated with the GCB subtype. Using immunohistochemical techniques, we examined 68 newly diagnosed de novo DLBCL cases (median follow-up 44 months, range 1 to 142 months) for the expression of c-REL, BCL-6, CD10, and MUM1/IRF4. Forty-four (65%) cases demonstrated positive c-REL nuclear expression. In this cohort of patients, the GCB phenotype was associated with a better overall survival (OS) than the non-GCB phenotype (Kaplan-Meier survival (KMS) analysis, p= 0.016, Breslow-Gehan-Wilcoxon test). In general, c-REL nuclear expression did not correlate with GCB vs. non- GCB phenotype, International Prognostic Index score, or OS. However, cases with a GCB phenotype and negative nuclear c-REL demonstrated better OS than cases with a GCB phenotype and positive nuclear c-REL (KMS analysis, p=0.045, Breslow-Gehan-Wilcoxon test), whereas in cases with non-GCB phenotype, the expression of c-REL did not significantly impact the prognosis. These results suggest that c-REL nuclear expression may be a prognostic factor in DLBCL and it may improve patient risk stratification in combination with GCB/non-GCB phenotyping.

Original languageEnglish (US)
Pages (from-to)20-26
Number of pages7
JournalJournal of Hematopathology
Issue number1
StatePublished - 2009


  • c-REL
  • Diffuse large B-cell lymphoma
  • Prognosis

ASJC Scopus subject areas

  • Hematology
  • Pathology and Forensic Medicine
  • Histology


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