BCL2 Family Related Genes Expression and Chemotherapy Response in Diffuse Large B-Cell Lymphoma

  Background and Objective: Approximately half of patients with diffuse large B-cell lymphoma are cured with current chemotherapy regimens. The purpose of this study was to evaluate Bax and Bcl2 expression and their relationship with the response to chemotherapy. Materials and Methods This study was a prospective analysis on 44 patients with diffuse large B-cell lymphoma. Their specimens were stained with immunohistochemistery method for Bax and Bcl2. The relationship between Bax/Bcl2 expression and the response to chemotherapy as well as some other prognostic factors were assessed. Results: Out of 44 patients, 29 were Bax+ and 15 Bax-, 31 Bcl2+ and 13 Bcl2-. We found a statistically significant relationship between IPI score and the response to chemotherapy (P = 0.002).  The response rates were relatively better (but not significant) in cases with Bax + compared to Bax – and in patients with Bcl2- compared to Bcl2 + tumors. The combination of  immunohistochemistery results for Bcl2 and Bax could predict relatively higher response rates in a way that those with Bax+ Bcl2- had a higher response compared to Bax- Bcl2+ ( 57%% VS.22%, p=0.15). Conclusion:  Although we found a relatively higher responses in our cases with Bax + vs. Bax - and in those with Bcl2- vs. Bcl2 +, the differences were not statistically significant. We suggest further studies to confirm whether the Bcl2 and Bax expressions have any effect on the response to chemotherapy and whether they could be considered as predictor factors for chemotherapy response.