Bcl-2 protein frequency in patients with high-risk diffuse large B-cell lymphoma

context and objective: gene expression and immunohistochemical profiling of diffuse large b-cell lymphoma (dlbcl) have revealed important prognostic subgroups: germinal center b-cell-like (gcb-like) dlbcl and activated b cell-like (abc-like) dlbcl. although few reports on high-risk dlbcl are available, the prognosis for the gcb-like subgroup has been shown to be better than that of the abc-like subgroup. the role of bcl-2 as a predictor of survival in dlbcl cases is unclear and its expression varies between the two subgroups of dlbcl. in this study, we analyzed the frequency and prognostic impact of bcl-2 protein expression in high-risk dlbcl cases. design and setting: retrospective cohort study among dlbcl patients treated at hospital das clínicas, faculdade de medicina da universidade de s？o paulo (hc-fmusp). methods: the prognostic impact of the expression of the proteins cd10, bcl-6, mum1 (multiple myeloma oncogene-1) and bcl-2 on high-risk dlbcl cases was evaluated by means of immunohistochemistry. seventy-three patients aged 18-60 years were evaluated for all these markers. results: twenty-four cases (32.9%) were gcb-like and 49 (67.1%) were abc-like, with no difference regarding complete remission, disease-free survival or overall survival rates. twenty-seven patients (37%) showed bcl-2 expression, which was the only independent factor predicting a worse prognosis for overall survival according to multivariate analysis. conclusion: bcl-2 protein was expressed in 37% of the high-risk dlbcl patients, without any difference between the abc-like dlbcl and gcb-like dlbcl cases.