Diffuse large B cell lymphoma (DLBCL) is not one disease, but it is at least 3 different diseases. DLBCL can be of different cell origin. The cell origin determines the prognosis in such lymphomas. The cell of origin can be of germinal center B-cell (GCB ) or from Activated B-cells (ABC), or from an in between group �Activated GCB�. The overall survival of DLBCL for 5 years is about 50%. But it is better for DLBCL of �GCB� origin, reaching 67% and much worse for the �ABC� group (16%) and 39% for the �Activated GCB� cell group. The protein expression in the GCB group is CD10, CD38, BCL6 positive; the ABC group is MUM1,CD138, and BCL-2 positive. The �in between group� which is �Activated Germinal center B� cell pattern has at least one of GCB markers (CD10, BCL-6 or CD38) and one activation marker MUM1 or CD138. Within the same group also, the higher the proliferation index (ki-76), the worse is the prognosis
In summary: in each CD20 positive DLBC lymphoma, other markers (CD10, BCL2, BCL6, CD38, CD138, MUM1 and ki-67) should be done to define the prognosis and possibly modify the chemotherapy accordingly
We, in the First Medical Laboratory, are dedicated to bring the best of laboratory medicine to clinical practice to Jordan
.Dr. Hussam Abu- Farsakh, M.D
Consultant Pathologist and Cytopathologist
American boards of Anatomic, Clinical Pathology and Cytopathology