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High intensity of cytoplasmic peroxiredoxin VI expression is associated with adverse outcome in diffuse large B-cell lymphoma independently of International Prognostic Index
  1. Milla Elvi Linnea Kuusisto1,
  2. Kirsi-Maria Haapasaari2,
  3. Taina Turpeenniemi-Hujanen1,
  4. Esa Jantunen3,
  5. Ylermi Soini4,
  6. Pekka Peroja1,
  7. Risto Bloigu5,
  8. Peeter Karihtala1,
  9. Outi Kuittinen1
  1. 1Department of Oncology and Radiotherapy, University of Oulu, Medical Research Center and Oulu University Hospital, Oulu, Finland
  2. 2Department of Pathology, University of Oulu and Oulu University Hospital, Oulu, Finland
  3. 3Department of Internal Medicine, Institute of Clinical Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
  4. 4Department of Pathology, University of Eastern Finland and Kuopio University Hospital, Cancer Center of Eastern Finland, Kuopio, Finland
  5. 5Medical Informatics and Statistics Research Group, University of Oulu, Oulu, Finland
  1. Correspondence to Milla Elvi Linnea Kuusisto, Department of Oncology and Radiotherapy, University of Oulu, Medical Research Center and Oulu University Hospital, Kajaanintie 50, Oulu 90220, Finland; milla.kuusisto{at}


Aims Diffuse large B-cell lymphoma (DLBCL) is an aggressive and potentially fatal disease. Prediction of risk of relapse is based on clinical markers. There is a need for more accurate biomarkers to select patients for more aggressive first-line treatments. Peroxiredoxins (Prxs) are a family of potent antioxidant proteins. Their prognostic role in DLBCL is unknown.

Methods Altogether, 103 diagnostic biopsy samples from patients with DLBCL were immunohistochemically stained for Prxs I, II, III, V and VI.

Results Strong Prx VI expression was associated with the presence of B-symptoms. There were no other significant associations with traditional risk factors. Five-year disease-specific survival was 68.6% in patients with high cytoplasmic Prx VI intensity vs 97.0% in those with low intensity. In multivariate analysis, high Prx VI expression (HR 12.846, 95% CI 1.722 to 95.807, p=0.013) was an independent risk factor of lymphoma-associated death not related to International Prognostic Index score (HR 2.514, 95% CI 1.040 to 6.073, p=0.041).

Conclusions High intensity of cytoplasmic Prx VI expression in pretreatment DLBCL samples predicts worse outcome in patients with DLBCL. Whether Prx VI is associated with chemoresistance, and therefore a poorer outcome, needs to be evaluated. If Prx VI is a predictive marker and it proves causality, it would be crucial to study Prx VI ability to become a target enzyme for treatment.


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