The Use of Molecular Profiling to Predict Survival after Chemotherapy for Diffuse Large-B-Cell Lymphoma
Andreas Rosenwald, M.D., George Wright, Ph.D., Wing C. Chan, M.D., Joseph M. Connors, M.D., Elias Campo, M.D., Richard I. Fisher, M.D., Randy D. Gascoyne, M.D., H. Konrad Muller-Hermelink, M.D., Erlend B. Smeland, M.D., Ph.D., Jena M. Giltnane, B.S., Elaine M. Hurt, Ph.D., Hong Zhao, M.S., Lauren Averett, B.A., Liming Yang, Ph.D., Wyndham H. Wilson, M.D., Ph.D., Elaine S. Jaffe, M.D., Richard Simon, D.Sc., Richard D. Klausner, M.D., John Powell, M.S., Patricia L. Duffey, R.N., Dan L. Longo, M.D., Timothy C. Greiner, M.D., Dennis D. Weisenburger, M.D., Warren G. Sanger, Ph.D., Bhavana J. Dave, Ph.D., James C. Lynch, Ph.D., Julie Vose, M.D., James O. Armitage, M.D., Emilio Montserrat, M.D., Armando López-Guillermo, M.D., Thomas M. Grogan, M.D., Thomas P. Miller, M.D., Michel LeBlanc, Ph.D., German Ott, M.D., Stein Kvaloy, M.D., Ph.D., Jan Delabie, M.D., Ph.D., Harald Holte, M.D., Ph.D., Peter Krajci, M.D., Ph.D., Trond Stokke, Ph.D., Louis M. Staudt, M.D., Ph.D., for the Lymphoma/Leukemia Molecular Profiling Project
Background The survival of patients with diffuse large-B-celllymphoma after chemotherapy is influenced by molecular featuresof the tumors. We used the gene-expression profiles of theselymphomas to develop a molecular predictor of survival.
Methods Biopsy samples of diffuse large-B-cell lymphoma from240 patients were examined for gene expression with the useof DNA microarrays and analyzed for genomic abnormalities. Subgroupswith distinctive gene-expression profiles were defined on thebasis of hierarchical clustering. A molecular predictor of riskwas constructed with the use of genes with expression patternsthat were associated with survival in a preliminary group of160 patients and was then tested in a validation group of 80patients. The accuracy of this predictor was compared with thatof the international prognostic index.
Results Three gene-expression subgroups germinal-centerB-celllike, activated B-celllike, and type 3 diffuselarge-B-cell lymphoma were identified. Two common oncogenicevents in diffuse large-B-cell lymphoma, bcl-2 translocationand c-rel amplification, were detected only in the germinal-centerB-celllike subgroup. Patients in this subgroup had thehighest five-year survival rate. To identify other moleculardeterminants of outcome, we searched for individual genes withexpression patterns that correlated with survival in the preliminarygroup of patients. Most of these genes fell within four gene-expressionsignatures characteristic of germinal-center B cells, proliferatingcells, reactive stromal and immune cells in the lymph node,or major-histocompatibility-complex class II complex. We used17 genes to construct a predictor of overall survival afterchemotherapy. This gene-based predictor and the internationalprognostic index were independent prognostic indicators.
Conclusions DNA microarrays can be used to formulate a molecularpredictor of survival after chemotherapy for diffuse large-B-celllymphoma.
Diffuse large-B-cell lymphoma, the most common type of lymphomain adults, can be cured by anthracycline-based chemotherapyin only 35 to 40 percent of patients.1 The multiple unsuccessfulattempts to increase this rate2 suggest that diffuse large-B-celllymphoma actually comprises several diseases that differ inresponsiveness to chemotherapy. Support for this idea comesfrom a study of gene-expression profiles, which identified twosubgroups of diffuse large-B-cell lymphoma that had differentoutcomes after multiagent chemotherapy.3 The germinal-centerB-celllike subgroup expressed genes characteristic ofnormal germinal-center B cells and were associated with a goodoutcome, whereas the activated B-celllike subgroup expressedgenes characteristic of activated blood B cells and were associatedwith a poor outcome.
Age, Eastern Cooperative Oncology Group (ECOG) performance status,tumor stage, lactate dehydrogenase level, and the number ofsites of extranodal disease also have prognostic value in diffuselarge-B-cell lymphoma, and they are included in the internationalprognostic index.4 Although the index is of value, it has notbeen used successfully to stratify patients for therapeutictrials.5
We hypothesized that gene-expression profiles of diffuse large-B-celllymphoma could be used independently of the international prognosticindex to predict the outcome of chemotherapy. Since the outcomesfor patients within the same subgroup of diffuse large-B-celllymphoma vary,3 we sought to identify individual genes thatcould influence survival within these subgroups.
Methods
Tumor-biopsy specimens and clinical data were obtained retrospectivelyfrom 240 patients with untreated diffuse large-B-cell lymphomawho had no previous history of lymphoma, according to a protocolapproved by the National Cancer Institute institutional reviewboard. A panel of eight hemopathologists confirmed the diagnosisof diffuse large-B-cell lymphoma in all patients and were ableto assign a histologic subtype to 236. Patients were selectedon the basis of the availability of tumor-biopsy specimens,without regard to the clinical outcome. All patients had receivedanthracycline-based chemotherapy, in most cases a regimen ofcyclophosphamide, doxorubicin, vincristine, and prednisone orsimilar regimens. Median follow-up was 2.8 years overall (7.3years for survivors), and 57 percent of patients died duringthis period. The median age of the patients was 63 years, and56 percent were men. According to the Ann Arbor classification,15 percent of patients had stage I disease, 31 percent had stageII, 20 percent had stage III, and 34 percent had stage IV.
"Lymphochip" DNA microarrays6 are composed of genes whose productsare preferentially expressed in lymphoid cells and genes thoughtor confirmed to play a part in cancer or immune function. Thesemicroarrays were constructed from 12,196 clones of complementaryDNA (i.e., microarray features) and were used to quantitatethe expression of messenger RNA in the tumors.3 Establishedprocedures were followed to detect the amplification of c-rel7and the translocation of bcl-2.8
Hierarchical clustering9 was used to define subgroups of diffuselarge-B-cell lymphoma. To create an outcome variable based ongene-expression studies, we divided the patients into two groups:the preliminary group comprised 160 patients, and the validationgroup comprised 80 patients. Within the preliminary group, thesignificance of the correlation between outcome (overall survivalafter chemotherapy) and gene-expression data from individualmicroarray features was determined with use of the Cox proportional-hazardsmodel. Genes that were associated with a good or a bad outcomeat a significance level of P<0.01 were assigned to gene-expressionsignatures, as described previously.10 These representativegenes were chosen because of their high variance in expression(i.e., they were among the top third of genes in variance ofgene-expression levels in the preliminary group). We used theaverage value for each signature and the value for the BMP6gene, a member of the transforming growth factor superfamilyof genes, to construct a multivariate Cox survival model accordingto the following formula: outcome-predictor score = (0.241 xthe average value of the proliferation signature) + (0.310 xvalue for BMP6) (0.290 x the average value of the germinal-centerB-cell signature) (0.311 x the average value of themajor-histocompatibility-complex [MHC] class II signature) (0.249 x the average value of the lymph-node signature). Thecoefficients in this formula were derived from the Cox model,and a high score indicates a poor outcome. We used the Waldtest to determine the significance of the association betweenthis model and the outcome in the preliminary group, the validationgroup, and the group as a whole and to assess the independenceof the risk groups defined by the international prognostic indexand the outcome predicated on gene-expression profiles. Allt-tests were two-sided except those used for the validationgroup; the results of one-sided t-tests are reported for thisgroup, since the analysis of the preliminary group indicatedthe direction of the effect. The data set used to determinethe outcome predictor and a detailed description of the statisticalmethods used are available as Supplementary Appendix 1 withthe full text of this article at http://www.nejm.org and athttp://llmpp.nih.gov/DLBCL.
Results
Molecular, Pathological, and Clinical Features of the Subgroups
We first determined whether we could identify the previouslydescribed gene-expression subgroups3 in the group of diffuselarge-B-cell lymphomas that we analyzed. We applied a hierarchical-clusteringalgorithm to group the lymphomas according to the expressionof 100 genes that distinguished between germinal-center B-celllikeand activated B-celllike diffuse large-B-cell lymphomasat a significance level of P<0.001 in the previous analysis3and found three large subgroups (Figure 1A). One had a highlevel of expression of the genes characteristic of germinal-centerB-celllike diffuse large-B-cell lymphoma and normal germinal-centerB cells, another expressed genes characteristic of activatedB-celllike diffuse large-B-cell lymphoma and mitogenicallyactivated blood B cells, and the third, termed type 3 diffuselarge-B-cell lymphoma, did not express either set of genes ata high level. The heterogeneity of expression within this thirdsubgroup indicates that it may consist of more than one typeof diffuse large-B-cell lymphoma.
Figure 1. Subgroups of Diffuse Large-B-Cell Lymphoma According to Gene-Expression Profiles.
Panel A shows the hierarchical clustering of diffuse large-B-cell lymphomas from 240 patients with untreated disease and 34 patients who had previously been treated or who had a preexisting low-grade lymphoma, according to the level of expression of 100 genes. Red areas indicate increased expression, and green areas decreased expression. Each column represents a single diffuse large-B-cell lymphoma, and each row represents a single gene. Genes that are characteristically expressed in germinal-center B-celllike diffuse large-B-cell lymphomas or activated B-celllike diffuse large-B-cell lymphomas are indicated. The dendrogram at the top shows the degree to which each diffuse large-B-cell lymphoma is related to the others with respect to gene expression. Panel B shows the number of samples with amplification of the c-rel locus and bcl-2 translocations in subgroups of diffuse large-B-cell lymphoma. The ratio of genomic copy number for the c-rel and 2-microglobulin loci was determined by a quantitative polymerase-chain-reaction assay, and ratios greater than 2 were considered to indicate c-rel amplification. The bcl-2 translocations were detected with the use of a polymerase-chain-reaction assay for the main break-point cluster region that is frequently involved in the t(14;18) translocation. Data are from patients who had untreated diffuse large-B-cell lymphomas without preexisting cancer. Panel C shows KaplanMeier estimates of overall survival after chemotherapy among the 240 previously untreated patients, according to the gene-expression subgroup.
The subgroups differed substantially with respect to two recurrentoncogenic events. The t(14;18) translocation involving the bcl-2gene and the amplification of the c-rel locus on chromosome2p occurred exclusively in germinal-center B-celllikediffuse large-B-cell lymphomas (Figure 1B). These findings supportthe view that the various subgroups represent different diseasesthat arise as a result of distinct mechanisms of malignant transformation.3,11
The clinical and pathological features of the three subgroupsare shown in Table 1. The most common histologic type of diffuselarge-B-cell lymphoma centroblastic monomorphic was found in 66 percent of the germinal-center B-celllikesubgroup but also in 32 percent of the activated B-celllikesubgroup and 27 percent of the type 3 subgroup. Centroblasticpolymorphic and immunoblastic subtypes were more common in activatedB-celllike and type 3 diffuse large-B-cell lymphomas,but they were also observed in the germinal-center B-celllikesubgroup. Thus, these three subgroups were not strictly relatedto a specific histologic subtype. With respect to clinical features,a significantly higher proportion of patients in the activatedB-celllike subgroup than in the other two groups wereolder than 60 years of age (P=0.05) and had an ECOG performancestatus of more than 1 (P=0.03), but the tumor subgroup did notcorrelate with the risk groups defined on the basis of the internationalprognostic index (P=0.44).
Table 1. Characteristics of Patients with Diffuse Large-B-Cell Lymphoma.
Overall survival after anthracycline-based chemotherapy differedsignificantly among the three subgroups (P<0.001) (Figure 1C).Patients with germinal-center B-celllike diffuselarge-B-cell lymphoma had a five-year survival rate of 60 percent,as compared with a rate of 39 percent for patients with diffusetype 3 large-B-cell lymphoma and 35 percent for those with activatedB-celllike diffuse large-B-cell lymphoma.
Correlation between Expression of Individual Genes and Outcome
Although the three subgroups may be viewed as distinct diseases,these divisions did not fully reflect the differences in survivalamong patients with diffuse large-B-cell lymphoma. For example,patients with germinal-center B-celllike diffuse large-B-celllymphoma had the best prognosis, but these patients still hada 36 percent risk of death within three years after treatment.The patients with activated B-celllike diffuse large-B-celllymphoma, by contrast, had the worst prognosis, but the five-yearsurvival rate of 35 percent suggests that some patients in thissubgroup may be cured by chemotherapy.
For these reasons, we used a Cox proportional-hazards modelto identify individual genes whose expression correlated withthe outcome. Data from 670 of 7399 microarray features weresignificantly associated with a good or a bad outcome in thepreliminary group (P<0.01); this number is greater than wouldbe expected by chance (P=0.005 with the use of a permutationtest) (Table 2).
Table 2. Use of Gene-Expression Profiles to Predict Outcome for Patients with Diffuse Large-B-Cell Lymphoma.
To classify the genes that were correlated with outcome, weused hierarchical clustering to group them into gene-expressionsignatures.3 A gene-expression signature is a group of genesexpressed in a specific cell lineage or stage of differentiationor during a particular biologic response. Many of the geneswe identified fell within previously described gene-expressionsignatures (Table 2) (see Supplementary Appendix 1 at http://www.nejm.org).Among the 162 microarray features associated with a favorableoutcome, 15 belonged to the signature that characterizes normalgerminal-center B cells,3 30 were in the lymph-node signatureof reactive nonmalignant cells in biopsy specimens of diffuselarge-B-cell lymphoma,3 and 35 were in the MHC class II signature.In the proliferation signature, which includes genes that arehighly expressed in dividing cells,3 287 of 1333 microarrayfeatures were associated with a poor outcome.
Since genes within the same gene-expression signature are probablyassociated with similar biologic aspects of a tumor, we combinedthe genes that were significantly associated with survival (P<0.01)within each signature. To minimize the number of genes in theoutcome predictor, we selected 16 genes that were highly variablein expression 3 germinal-center B-cell genes, 4 MHCclass II genes, 6 lymph-node genes, and 3 proliferation genes and averaged the expression values for genes belongingto the same signature (Table 2). In a univariate analysis, thesefour signatures were found to predict survival in the preliminarygroup, in the validation group, and in the group of all patients(Table 2).
Individual genes that were not in these four signatures butthat predicted the likelihood of survival in a univariate analysisof the preliminary group (P<0.01) were evaluated to determinewhether these variables increased the predictive value of thetest. The only gene that significantly increased the predictivevalue (P=0.005) was BMP6, which was associated with a poor outcome.
The final model combined the four gene-expression signaturesand BMP6. Each case of diffuse large-B-cell lymphoma was assigneda score that was calculated as the weighted sum of these components,optimized by a Cox proportional-hazards model of overall survivalwithin the preliminary group. The score, expressed as a continuousvariable, correlated significantly with the clinical outcomein both the preliminary group (P<0.001) and the validationgroup (P<0.001), indicating that the results are reproducible.The score ranged from 1.7 to 2.4, with a standard deviationof 0.72, and each unit increase in the score induced an increasein the relative risk of death by a factor of 2.7 (95 percentconfidence interval, 2.11 to 3.51).
The patients were ranked according to their score and dividedinto quartiles (from highest to lowest scores). KaplanMeierplots of overall survival showed distinct differences in thefive-year survival rates in the various quartiles in both thepreliminary and validation groups (Figure 2). In the group asa whole, the five-year survival rates were 73 percent in quartile1, 71 percent in quartile 2, 34 percent in quartile 3, and 15percent in quartile 4 (Figure 2C).
Figure 2. KaplanMeier Estimates of Overall Survival among Patients with Diffuse Large-B-Cell Lymphoma in the Preliminary Group (Panel A), the Validation Group (Panel B), and All Patients (Panel C).
Comparison of the Gene-ExpressionBased Outcome Predictor and the International Prognostic Index
The international-prognostic-index scores (Figure 3A) and thegene-expressionbased scores were independent predictorsof survival in the preliminary group (P<0.001) and the validationgroup (P=0.002). In a multivariate Cox model that combined boththe international-prognostic-index scores and the gene-expressionbasedscores, each unit increase in the latter score increased therelative risk of death by a factor of 2.6 (95 percent confidenceinterval, 2.02 to 3.48).
Figure 3. KaplanMeier Estimates of Survival According to the International Prognostic Index (IPI) Alone (Panel A) and to the International Prognostic Index and the Gene-Expression Profile (Panel B).
Panel A shows overall survival among patients in the low-risk group according to the international prognostic index score (a score of 0 to 1), those in the intermediate-risk group (indicated by a score of 2 to 3), and those in the high-risk group (indicated by a score of 4 to 5). Panel B shows overall survival among patients in the various IPI risk groups in the preliminary group, the validation group, and the group as a whole, stratified according to the quartile of the gene-expressionbased outcome-predictor scores; quartiles 1 and 2 and quartiles 3 and 4 were merged. Higher quartiles indicate a poorer outcome. A few patients in the preliminary and validation groups were assigned to different gene-expressionbased outcome-predictor groups when the groups were combined owing to slight differences in the cutoff points for each quartile within each group of patients.
KaplanMeier plots of overall survival showed the independenceof the international-prognostic-index score and the gene-expressionbasedscore (Figure 3B). For these plots, we combined quartiles 1and 2 into one group and quartiles 3 and 4 into a second group.These two groups had significantly different outcomes in theanalysis of patients with low or intermediate risk accordingto their international-prognostic-index scores, and this differencewas observed in both the preliminary and the validation groups.The gene-expressionbased method also identified the fewpatients in the high-risk group according to the international-prognostic-indexscore who were long-term survivors (Figure 3B).
Relation between Gene-ExpressionBased Score and Subtype of Diffuse Large-B-Cell Lymphoma
Since overall survival differed in the three subgroups of diffuselarge-B-cell lymphoma (Figure 1C), we investigated whether thecomponents of the outcome predictor were differentially expressedby these subgroups. As expected, the germinal-center B-cellsignature was much more highly expressed in the germinal-centerB-cell-like subgroup than in the other two subgroups (Figure 4A).The activated B-celllike subgroup had the highestlevel of expression of the proliferation signature and BMP6but the lowest level of expression of the lymph-node signature.On the other hand, the level of expression of the MHC classII signature was similar among the three subgroups. The gene-expressionbasedscore was highest in the activated B-cell like group,intermediate in the type 3 subgroup, and lowest in the germinal-centerB-celllike subgroup (Figure 4A), demonstrating that thisapproach incorporates the clinical distinctions among the subgroupsof diffuse large-B-cell lymphoma.
Figure 4. Relation between the Gene-ExpressionBased Outcome-Predictor Score and the Subgroup of Diffuse Large-B-Cell Lymphoma.
Panel A shows the mean (±SE) expression value (after log2 transformation) of each outcome-predictor component and the score. Panel B shows the level of expression of variables in the outcome predictor and the scores in the three subgroups of lymphoma. Panel C shows KaplanMeier plots of overall survival in the subgroups, stratified according to the quartile of risk reflected by the gene-expressionbased score. Quartiles 1 and 2 and quartiles 3 and 4 were merged. Higher quartiles indicate a poorer outcome. MHC denotes major histocompatibility complex.
Nonetheless, the components of the outcome predictor were differentiallyexpressed within each subgroup (Figure 4B), and the predictorscore could be used to subdivide the patients within each subgroupinto distinct risk groups (Figure 4C). This feature accountsfor the predictor's greater prognostic power as compared withthat derived from the use of subgroups of diffuse large-B-celllymphoma.
Discussion
We have developed a method to predict the likelihood of survivalafter chemotherapy for diffuse large-B-cell lymphoma that isbased on patterns of gene expression in biopsy specimens ofthe lymphoma. This molecular method and the clinically basedinternational prognostic index were found to be independentpredictors of the prognosis. The international prognostic indexhas not proved effective in stratifying patients with diffuselarge-B-cell lymphoma for therapeutic trials,5 but we thinkthat the gene-expressionbased method might serve thispurpose.
Our analysis of gene-expression profiles integrated two complementaryapproaches to outcome prediction. In the first approach, weused hierarchical clustering to identify subgroups that differedwith respect to the expression of hundreds of genes. With theuse of this clustering method, two recurrent genetic abnormalities the t(14;18) translocation and amplification of thec-rel locus were found exclusively in the germinal-centerB-celllike subgroup. This finding supports our view thatthe subgroups of diffuse large-B-cell lymphoma represent distinctdisease entities.3 Further support for this idea is suppliedby the finding that the germinal-center B-celllike subgrouphad a significantly greater likelihood of survival after chemotherapythan did the activated B-celllike and type 3 subgroups.
In the second approach, we used clinical and gene-expressiondata to identify individual genes that predicted the outcomeand then combined these variables into a multivariate model.This model incorporated differences in the levels of gene expressionamong the subgroups of diffuse large-B-cell lymphoma that influencedthe outcome, as well as other differences in gene expressionthat were associated with the likelihood of survival.
The predictive genes fell within four biologic groups definedon the basis of gene-expression signatures. The proliferationsignature was the best predictor of an adverse outcome a finding that is consistent with those of previous analysesof tumor-cell proliferation in diffuse large-B-cell lymphoma.12,13Two of the gene-expression signatures that were associated witha good outcome suggest that the immune response to the tumorcells may be a crucial determinant of survival after chemotherapy.The MHC class II gene-expression signature correlated with agood outcome, suggesting that antigen presentation to the immunesystem has a role in therapeutic responses.14 The genes in thelymph-node signature that were associated with a good outcomeencode components of the extracellular matrix and connective-tissuegrowth factor, a mediator of fibrosis that promotes the synthesisof the matrix.15 Sclerotic reactions occur in some cases ofdiffuse large-B-cell lymphoma, and the lymph-node signaturemay reflect these reactions. Other genes in the lymph-node signatureare characteristically expressed in macrophages and naturalkiller cells, again suggesting that an antitumor immune responseimproves survival after chemotherapy.
The prognostically favorable germinal-center B-cell gene-expressionsignature is notable because cell lines derived from germinal-centerB-celllike diffuse large-B-cell lymphomas have decreasedactivity of the nuclear factor B signaling pathway.16 This protectivepathway interferes with the apoptotic effect of chemotherapy.17In contrast, in activated B-celllike diffuse large-B-celllymphomas, there is constitutive activation of this pathway,16which, in principle, could block the apoptosis induced by chemotherapyand thus account for the relatively poor outcome in this subgroup.
Our outcome predictor may help identify patients with diffuselarge-B-cell lymphoma who are unlikely to be cured by conventionaltherapy. On the basis of their predictor scores, one quarterof the 240 patients in this study could be assigned to a riskgroup with a five-year survival rate of 15 percent. Among patientsat intermediate risk according to the international-prognostic-indexscore, use of the outcome predictor indicated that 55 percentof these patients had a five-year survival rate of 18 percent,whereas this group of patients had a five-year survival rateof 41 percent overall. Even among patients with a low risk accordingto the international-prognostic-index score, use of the outcomepredictor showed that 16 percent of the patients in this grouphad a five-year survival rate of only 28 percent (data not shown).
One of the features of our analysis is that the outcome predictorinvolves a small number of genes and thus multiplexed quantitativereverse-transcriptasepolymerase-chain-reaction assaysor customized DNA microarrays could easily be developed forclinical application. Regardless of the eventual choice of technique,our study highlights the need to use molecular diagnosis inpatients with diffuse large-B-cell lymphoma, since these patientshave molecularly distinct diseases that may require individualizedand molecularly targeted therapies.
Supported by a Director's Challenge grant (UO1-CA84967) fromthe National Cancer Institute, by the Center for Cancer Researchof the National Cancer Institute, and by the Cancer Genome AnatomyProject. Dr. Rosenwald was supported in part by the DeutscheKrebshilfe, Bonn, Germany. Ms. Averett was a Howard Hughes MedicalInstitute Research Scholar at the National Institutes of Healthduring the study.
We are indebted to Bob Strausberg, Narajan Bhat, and Butch Hopkinsfor preparing the messenger RNA reference pool and for helpfuldiscussions, and to Ken Buetow and Jenny Kelly for verifyingthe sequence of Lymphochip clones.
Source Information
From the Metabolism Branch, Center for Cancer Research (A.R., L.M.S.), and the Biometric Research Branch, Division of Cancer Treatment and Diagnosis (G.W.), National Cancer Institute, National Institutes of Health, Bethesda, Md.; the Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha (W.C.C.); British Columbia Cancer Center, Vancouver, B.C., Canada (J.M.C., R.D.G.); Hospital Clinic, University of Barcelona, Barcelona, Spain (E.C.); Southwest Oncology Group and James P. Wilmot Cancer Center, University of Rochester School of Medicine, Rochester, N.Y. (R.I.F.); the Department of Pathology, University of Würzburg, Würzburg, Germany (H.K.M.-H.); and the Department of Immunology, Norwegian Radium Hospital, Oslo, Norway (E.B.S.). Other authors were Jena M. Giltnane, B.S., Elaine M. Hurt, Ph.D., Hong Zhao, M.S., Lauren Averett, B.A., Liming Yang, Ph.D., Wyndham H. Wilson, M.D., Ph.D., Elaine S. Jaffe, M.D., Richard Simon, D.Sc., and Richard D. Klausner, M.D., National Cancer Institute, National Institutes of Health (NIH), Bethesda, Md.; John Powell, M.S., Center for Information Technology, NIH, Bethesda, Md.; Patricia L. Duffey, R.N., and Dan L. Longo, M.D., National Institute on Aging, NIH Gerontology Research Center, Baltimore; Timothy C. Greiner, M.D., Dennis D. Weisenburger, M.D., Warren G. Sanger, Ph.D., Bhavana J. Dave, Ph.D., James C. Lynch, Ph.D., Julie Vose, M.D., and James O. Armitage, M.D., University of Nebraska Medical Center, Omaha; Emilio Montserrat, M.D., and Armando López-Guillermo, M.D., Hospital Clinic, University of Barcelona, Barcelona, Spain; Thomas M. Grogan, M.D., and Thomas P. Miller, M.D., Southwest Oncology Group and University of Arizona Cancer Center, Tucson; Michel LeBlanc, Ph.D., Southwest Oncology Group and Fred Hutchinson Cancer Research Center, Seattle; German Ott, M.D., University of Würzburg, Würzburg, Germany; and Stein Kvaloy, M.D., Ph.D., Jan Delabie, M.D., Ph.D., Harald Holte, M.D., Ph.D., Peter Krajci, M.D., Ph.D., and Trond Stokke, Ph.D., Norwegian Radium Hospital, Oslo, Norway.
Address reprint requests to Dr. Staudt at the Metabolism Branch, Center for Cancer Research, National Cancer Institute, Bldg. 10, Rm. 4N114, National Institutes of Health, Bethesda, MD 20892, or at lstaudt{at}mail.nih.gov.
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Molecular Profiling of Lymphoma
Akhtar S., Copur M. S., Ledakis P., Bolton M., Staudt L. M., the Lymphoma/Leukemia Molecular Profiling Project
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[Abstract][Full Text]
Bernd, H.-W., Ziepert, M., Thorns, C., Klapper, W., Wacker, H.-H., Hummel, M., Stein, H., Hansmann, M.-L., Ott, G., Rosenwald, A., Muller-Hermelink, H.-K., Barth, T. F. E., Moller, P., Cogliatti, S. B., Pfreundschuh, M., Schmitz, N., Trumper, L., Holler, S., Loffler, M., Feller, A. C., for the German High Grade Non-Hodgkin's Lymphoma S,
(2009). Loss of HLA-DR expression and immunoblastic morphology predict adverse outcome in diffuse large B-cell lymphoma - analyses of cases from two prospective randomized clinical trials. haematol
94: 1569-1580
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Ferch, U., Kloo, B., Gewies, A., Pfander, V., Duwel, M., Peschel, C., Krappmann, D., Ruland, J.
(2009). Inhibition of MALT1 protease activity is selectively toxic for activated B cell-like diffuse large B cell lymphoma cells. JEM
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Chadburn, A., Chiu, A., Lee, J. Y., Chen, X., Hyjek, E., Banham, A. H., Noy, A., Kaplan, L. D., Sparano, J. A., Bhatia, K., Cesarman, E.
(2009). Immunophenotypic Analysis of AIDS-Related Diffuse Large B-Cell Lymphoma and Clinical Implications in Patients From AIDS Malignancies Consortium Clinical Trials 010 and 034. JCO
27: 5039-5048
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Gentles, A. J., Alizadeh, A. A., Lee, S.-I., Myklebust, J. H., Shachaf, C. M., Shahbaba, B., Levy, R., Koller, D., Plevritis, S. K.
(2009). A pluripotency signature predicts histologic transformation and influences survival in follicular lymphoma patients. Blood
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Oura, T., Matsui, S., Kawakami, K.
(2009). Sample size calculations for controlling the distribution of false discovery proportion in microarray experiments. Biostatistics
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Honma, K., Tsuzuki, S., Nakagawa, M., Tagawa, H., Nakamura, S., Morishima, Y., Seto, M.
(2009). TNFAIP3/A20 functions as a novel tumor suppressor gene in several subtypes of non-Hodgkin lymphomas. Blood
114: 2467-2475
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Choi, W. W.L., Weisenburger, D. D., Greiner, T. C., Piris, M. A., Banham, A. H., Delabie, J., Braziel, R. M., Geng, H., Iqbal, J., Lenz, G., Vose, J. M., Hans, C. P., Fu, K., Smith, L. M., Li, M., Liu, Z., Gascoyne, R. D., Rosenwald, A., Ott, G., Rimsza, L. M., Campo, E., Jaffe, E. S., Jaye, D. L., Staudt, L. M., Chan, W. C.
(2009). A New Immunostain Algorithm Classifies Diffuse Large B-Cell Lymphoma into Molecular Subtypes with High Accuracy. Clin. Cancer Res.
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Aster, J., Kutok, J.
(2009). Complexity Made Simple in Diffuse Large B-Cell Lymphoma. Clin. Cancer Res.
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Maxwell, S. A., Li, Z., Jaya, D., Ballard, S., Ferrell, J., Fu, H.
(2009). 14-3-3{zeta} Mediates Resistance of Diffuse Large B Cell Lymphoma to an Anthracycline-based Chemotherapeutic Regimen. J. Biol. Chem.
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Leich, E., Salaverria, I., Bea, S., Zettl, A., Wright, G., Moreno, V., Gascoyne, R. D., Chan, W.-C., Braziel, R. M., Rimsza, L. M., Weisenburger, D. D., Delabie, J., Jaffe, E. S., Lister, A., Fitzgibbon, J., Staudt, L. M., Hartmann, E. M., Mueller-Hermelink, H.-K., Campo, E., Ott, G., Rosenwald, A.
(2009). Follicular lymphomas with and without translocation t(14;18) differ in gene expression profiles and genetic alterations. Blood
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Sohn, I., Kim, J., Jung, S.-H., Park, C.
(2009). Gradient lasso for Cox proportional hazards model. Bioinformatics
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Kim, S.-W., Rai, D., McKeller, M. R., Aguiar, R. C. T.
(2009). Rational combined targeting of phosphodiesterase 4B and SYK in DLBCL. Blood
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Dunleavy, K., Pittaluga, S., Czuczman, M. S., Dave, S. S., Wright, G., Grant, N., Shovlin, M., Jaffe, E. S., Janik, J. E., Staudt, L. M., Wilson, W. H.
(2009). Differential efficacy of bortezomib plus chemotherapy within molecular subtypes of diffuse large B-cell lymphoma. Blood
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Grange, F., Antonicelli, F.
(2009). Cutaneous Lymphomas: What Can We Learn From Location?. Arch Dermatol
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Bacher, U., Kohlmann, A., Haferlach, T.
(2009). Perspectives of gene expression profiling for diagnosis and therapy in haematological malignancies. Brief Funct Genomic Proteomic
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Zhang, J., Jima, D. D., Jacobs, C., Fischer, R., Gottwein, E., Huang, G., Lugar, P. L., Lagoo, A. S., Rizzieri, D. A., Friedman, D. R., Weinberg, J. B., Lipsky, P. E., Dave, S. S.
(2009). Patterns of microRNA expression characterize stages of human B-cell differentiation. Blood
113: 4586-4594
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Lancashire, L. J., Lemetre, C., Ball, G. R.
(2009). An introduction to artificial neural networks in bioinformatics--application to complex microarray and mass spectrometry datasets in cancer studies. Brief Bioinform
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Shaffer, A. L., Emre, N.C. T., Romesser, P. B., Staudt, L. M.
(2009). IRF4: Immunity. Malignancy! Therapy?. Clin. Cancer Res.
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Johnson, N. A., Boyle, M., Bashashati, A., Leach, S., Brooks-Wilson, A., Sehn, L. H., Chhanabhai, M., Brinkman, R. R., Connors, J. M., Weng, A. P., Gascoyne, R. D.
(2009). Diffuse large B-cell lymphoma: reduced CD20 expression is associated with an inferior survival. Blood
113: 3773-3780
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Malumbres, R., Sarosiek, K. A., Cubedo, E., Ruiz, J. W., Jiang, X., Gascoyne, R. D., Tibshirani, R., Lossos, I. S.
(2009). Differentiation stage-specific expression of microRNAs in B lymphocytes and diffuse large B-cell lymphomas. Blood
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Hagemann, T., Biswas, S. K., Lawrence, T., Sica, A., Lewis, C. E.
(2009). Regulation of macrophage function in tumors: the multifaceted role of NF-{kappa}B. Blood
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Ma, S., Kosorok, M. R.
(2009). Identification of differential gene pathways with principal component analysis. Bioinformatics
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Huang, M., Itahana, K., Zhang, Y., Mitchell, B. S.
(2009). Depletion of Guanine Nucleotides Leads to the Mdm2-Dependent Proteasomal Degradation of Nucleostemin. Cancer Res.
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Rimsza, L. M., Chan, W. C., Gascoyne, R. D., Campo, E., Jaffe, E. S., Staudt, L. M., Delabie, J., Rosenwald, A., Murphy, S. P.
(2009). CIITA or RFX coding region loss of function mutations occur rarely in diffuse large B-cell lymphoma cases and cell lines with low levels of major histocompatibility complex class II expression. haematol
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Overdevest, J. B., Theodorescu, D., Lee, J. K.
(2009). Utilizing the Molecular Gateway: The Path to Personalized Cancer Management. Clin. Chem.
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Lee, R. V., Green, C. A., Negrea, O. G., Dodson, S., Farrell, S. K., Hewitt, J. E., Jago, T., Ramsey, C. E., Cato, T., Crawford, E., Henley, D. C., Phelan, M. C., Potter, N. T.
(2009). B-Cell Lymphoma With Intermediate- to High-Grade Features and Different Immunophenotypic Profiles Involving Separate Anatomic Sites With a Good Response to R-CHOP. Lab Med
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de Jong, D, Xie, W, Rosenwald, A, Chhanabhai, M, Gaulard, P, Klapper, W, Lee, A, Sander, B, Thorns, C, Campo, E, Molina, T, Hagenbeek, A, Horning, S, Lister, A, Raemaekers, J, Salles, G, Gascoyne, R D, Weller, E
(2009). Immunohistochemical prognostic markers in diffuse large B-cell lymphoma: validation of tissue microarray as a prerequisite for broad clinical applications (a study from the Lunenburg Lymphoma Biomarker Consortium). J. Clin. Pathol.
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Chng, W. J., Remstein, E. D., Fonseca, R., Bergsagel, P. L., Vrana, J. A., Kurtin, P. J., Dogan, A.
(2009). Gene expression profiling of pulmonary mucosa-associated lymphoid tissue lymphoma identifies new biologic insights with potential diagnostic and therapeutic applications. Blood
113: 635-645
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Mutch, D. M, Tordjman, J., Pelloux, V., Hanczar, B., Henegar, C., Poitou, C., Veyrie, N., Zucker, J.-D., Clement, K.
(2009). Needle and surgical biopsy techniques differentially affect adipose tissue gene expression profiles. Am. J. Clin. Nutr.
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Takeuchi, I., Tagawa, H., Tsujikawa, A., Nakagawa, M., Katayama-Suguro, M., Guo, Y., Seto, M.
(2009). The potential of copy number gains and losses, detected by array-based comparative genomic hybridization, for computational differential diagnosis of B-cell lymphomas and genetic regions involved in lymphomagenesis. haematol
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Onciu, M.
(2009). The Pathologist's Perspective on Challenging Pediatric Lymphomas: Update on the Pathobiology of Uncommon Childhood Lymphomas. Am Soc Clin Oncol Ed Book
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Montesinos-Rongen, M., Siebert, R., Deckert, M.
(2009). Primary lymphoma of the central nervous system: just DLBCL or not?. Blood
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Lee, S.
(2008). Mistakes in validating the accuracy of a prediction classifier in high-dimensional but small-sample microarray data. Stat Methods Med Res
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Jaffe, E. S., Harris, N. L., Stein, H., Isaacson, P. G.
(2008). Classification of lymphoid neoplasms: the microscope as a tool for disease discovery. Blood
112: 4384-4399
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Lenz, G., Wright, G., Dave, S.S., Xiao, W., Powell, J., Zhao, H., Xu, W., Tan, B., Goldschmidt, N., Iqbal, J., Vose, J., Bast, M., Fu, K., Weisenburger, D.D., Greiner, T.C., Armitage, J.O., Kyle, A., May, L., Gascoyne, R.D., Connors, J.M., Troen, G., Holte, H., Kvaloy, S., Dierickx, D., Verhoef, G., Delabie, J., Smeland, E.B., Jares, P., Martinez, A., Lopez-Guillermo, A., Montserrat, E., Campo, E., Braziel, R.M., Miller, T.P., Rimsza, L.M., Cook, J.R., Pohlman, B., Sweetenham, J., Tubbs, R.R., Fisher, R.I., Hartmann, E., Rosenwald, A., Ott, G., Muller-Hermelink, H.-K., Wrench, D., Lister, T.A., Jaffe, E.S., Wilson, W.H., Chan, W.C., Staudt, L.M., the Lymphoma/Leukemia Molecular Profiling Project,
(2008). Stromal Gene Signatures in Large-B-Cell Lymphomas. NEJM
359: 2313-2323
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Libra, M., Castellano, G., Baritaki, S., Huerta-Yepez, S., Ligresti, G., Militello, L., Malaponte, G., Stivala, F., Canevari, S., Bonavida, B.
(2008). Expression, Role in Transformation and Prognostic Significance of the Transcription Factor Yin Yang 1 (YY1) in Non-Hodgkin's Lymphoma: Analyses in NHL Tissues by Experimental and Bioinformatic Approaches. ASH ANNUAL MEETING ABSTRACTS
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Lu, X., Malumbres, R., Shields, B., Jiang, X., Sarosiek, K. A., Natkunam, Y., Tiganis, T., Lossos, I. S.
(2008). PTP1B is a negative regulator of interleukin 4-induced STAT6 signaling. Blood
112: 4098-4108
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Rimsza, L. M., LeBlanc, M. L., Unger, J. M., Miller, T. P., Grogan, T. M., Persky, D. O., Martel, R. R., Sabalos, C. M., Seligmann, B., Braziel, R. M., Campo, E., Rosenwald, A., Connors, J. M., Sehn, L. H., Johnson, N., Gascoyne, R. D.
(2008). Gene expression predicts overall survival in paraffin-embedded tissues of diffuse large B-cell lymphoma treated with R-CHOP. Blood
112: 3425-3433
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Young, K. H., Leroy, K., Moller, M. B., Colleoni, G. W. B., Sanchez-Beato, M., Kerbauy, F. R., Haioun, C., Eickhoff, J. C., Young, A. H., Gaulard, P., Piris, M. A., Oberley, T. D., Rehrauer, W. M., Kahl, B. S., Malter, J. S., Campo, E., Delabie, J., Gascoyne, R. D., Rosenwald, A., Rimsza, L., Huang, J., Braziel, R. M., Jaffe, E. S., Wilson, W. H., Staudt, L. M., Vose, J. M., Chan, W. C., Weisenburger, D. D., Greiner, T. C.
(2008). Structural profiles of TP53 gene mutations predict clinical outcome in diffuse large B-cell lymphoma: an international collaborative study. Blood
112: 3088-3098
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Decaux, O., Lode, L., Magrangeas, F., Charbonnel, C., Gouraud, W., Jezequel, P., Attal, M., Harousseau, J.-L., Moreau, P., Bataille, R., Campion, L., Avet-Loiseau, H., Minvielle, S.
(2008). Prediction of Survival in Multiple Myeloma Based on Gene Expression Profiles Reveals Cell Cycle and Chromosomal Instability Signatures in High-Risk Patients and Hyperdiploid Signatures in Low-Risk Patients: A Study of the Intergroupe Francophone du Myelome. JCO
26: 4798-4805
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Lu, W., Li, L.
(2008). Boosting method for nonlinear transformation models with censored survival data. Biostatistics
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Fu, K., Weisenburger, D. D., Choi, W. W.L., Perry, K. D., Smith, L. M., Shi, X., Hans, C. P., Greiner, T. C., Bierman, P. J., Bociek, R. G., Armitage, J. O., Chan, W. C., Vose, J. M.
(2008). Addition of Rituximab to Standard Chemotherapy Improves the Survival of Both the Germinal Center B-Cell-Like and Non-Germinal Center B-Cell-Like Subtypes of Diffuse Large B-Cell Lymphoma. JCO
26: 4587-4594
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Li, Z., Liu, B., Maminishkis, A., Mahesh, S. P., Yeh, S., Lew, J., Lim, W. K., Sen, H. N., Clarke, G., Buggage, R., Miller, S. S., Nussenblatt, R. B.
(2008). Gene Expression Profiling in Autoimmune Noninfectious Uveitis Disease. J. Immunol.
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Amara, K., Trimeche, M., Ziadi, S., Laatiri, A., Hachana, M., Korbi, S.
(2008). Prognostic significance of aberrant promoter hypermethylation of CpG islands in patients with diffuse large B-cell lymphomas. Ann Oncol
19: 1774-1786
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Habermann, T. M., Wang, S. S., Maurer, M. J., Morton, L. M., Lynch, C. F., Ansell, S. M., Hartge, P., Severson, R. K., Rothman, N., Davis, S., Geyer, S. M., Cozen, W., Chanock, S. J., Cerhan, J. R.
(2008). Host immune gene polymorphisms in combination with clinical and demographic factors predict late survival in diffuse large B-cell lymphoma patients in the pre-rituximab era. Blood
112: 2694-2702
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Lenz, G., Wright, G. W., Emre, N. C. T., Kohlhammer, H., Dave, S. S., Davis, R. E., Carty, S., Lam, L. T., Shaffer, A. L., Xiao, W., Powell, J., Rosenwald, A., Ott, G., Muller-Hermelink, H. K., Gascoyne, R. D., Connors, J. M., Campo, E., Jaffe, E. S., Delabie, J., Smeland, E. B., Rimsza, L. M., Fisher, R. I., Weisenburger, D. D., Chan, W. C., Staudt, L. M.
(2008). Molecular subtypes of diffuse large B-cell lymphoma arise by distinct genetic pathways. Proc. Natl. Acad. Sci. USA
105: 13520-13525
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Schmidlin, H., Diehl, S. A., Nagasawa, M., Scheeren, F. A., Schotte, R., Uittenbogaart, C. H., Spits, H., Blom, B.
(2008). Spi-B inhibits human plasma cell differentiation by repressing BLIMP1 and XBP-1 expression. Blood
112: 1804-1812
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John, T., Black, M. A., Toro, T. T., Leader, D., Gedye, C. A., Davis, I. D., Guilford, P. J., Cebon, J. S.
(2008). Predicting Clinical Outcome through Molecular Profiling in Stage III Melanoma. Clin. Cancer Res.
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Klapper, W., Szczepanowski, M., Burkhardt, B., Berger, H., Rosolowski, M., Bentink, S., Schwaenen, C., Wessendorf, S., Spang, R., Moller, P., Hansmann, M. L., Bernd, H.-W., Ott, G., Hummel, M., Stein, H., Loeffler, M., Trumper, L., Zimmermann, M., Reiter, A., Siebert, R., for the "Molecular Mechanisms in Malignant Lymphom,
(2008). Molecular profiling of pediatric mature B-cell lymphoma treated in population-based prospective clinical trials. Blood
112: 1374-1381
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Jiang, Y., Casey, G., Lavery, I. C., Zhang, Y., Talantov, D., Martin-McGreevy, M., Skacel, M., Manilich, E., Mazumder, A., Atkins, D., Delaney, C. P., Wang, Y.
(2008). Development of a Clinically Feasible Molecular Assay to Predict Recurrence of Stage II Colon Cancer. J. Mol. Diagn.
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Dittrich, M. T., Klau, G. W., Rosenwald, A., Dandekar, T., Muller, T.
(2008). Identifying functional modules in protein-protein interaction networks: an integrated exact approach. Bioinformatics
24: i223-i231
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Malumbres, R., Chen, J., Tibshirani, R., Johnson, N. A., Sehn, L. H., Natkunam, Y., Briones, J., Advani, R., Connors, J. M., Byrne, G. E., Levy, R., Gascoyne, R. D., Lossos, I. S.
(2008). Paraffin-based 6-gene model predicts outcome in diffuse large B-cell lymphoma patients treated with R-CHOP. Blood
111: 5509-5514
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Wilson, W. H., Dunleavy, K., Pittaluga, S., Hegde, U., Grant, N., Steinberg, S. M., Raffeld, M., Gutierrez, M., Chabner, B. A., Staudt, L., Jaffe, E. S., Janik, J. E.
(2008). Phase II Study of Dose-Adjusted EPOCH and Rituximab in Untreated Diffuse Large B-Cell Lymphoma With Analysis of Germinal Center and Post-Germinal Center Biomarkers. JCO
26: 2717-2724
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Nakamura, S., Ye, H., Bacon, C. M., Goatly, A., Liu, H., Kerr, L., Banham, A. H., Streubel, B., Yao, T., Tsuneyoshi, M., Savio, A., Takeshita, M., Dartigues, P., Ruskone-Fourmestraux, A., Matsumoto, T., Iida, M., Du, M.-Q.
(2008). Translocations Involving the Immunoglobulin Heavy Chain Gene Locus Predict Better Survival in Gastric Diffuse Large B-Cell Lymphoma. Clin. Cancer Res.
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Persky, D. O., Unger, J. M., Spier, C. M., Stea, B., LeBlanc, M., McCarty, M. J., Rimsza, L. M., Fisher, R. I., Miller, T. P.
(2008). Phase II Study of Rituximab Plus Three Cycles of CHOP and Involved-Field Radiotherapy for Patients With Limited-Stage Aggressive B-Cell Lymphoma: Southwest Oncology Group Study 0014. JCO
26: 2258-2263
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Demissie, M., Mascialino, B., Calza, S., Pawitan, Y.
(2008). Unequal group variances in microarray data analyses. Bioinformatics
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Dierlamm, J., Murga Penas, E. M., Bentink, S., Wessendorf, S., Berger, H., Hummel, M., Klapper, W., Lenze, D., Rosenwald, A., Haralambieva, E., Ott, G., Cogliatti, S. B., Moller, P., Schwaenen, C., Stein, H., Loffler, M., Spang, R., Trumper, L., Siebert, R., for the Deutsche Krebshilfe Network Project "Molec,
(2008). Gain of chromosome region 18q21 including the MALT1 gene is associated with the activated B-cell-like gene expression subtype and increased BCL2 gene dosage and protein expression in diffuse large B-cell lymphoma. haematol
93: 688-696
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Russom, A., Sethu, P., Irimia, D., Mindrinos, M. N., Calvano, S. E., Garcia, I., Finnerty, C., Tannahill, C., Abouhamze, A., Wilhelmy, J., Lopez, M. C., Baker, H. V., Herndon, D. N., Lowry, S. F., Maier, R. V., Davis, R. W., Moldawer, L. L., Tompkins, R. G., Toner, M., the Inflammation and Host Response to Injury Large,
(2008). Microfluidic Leukocyte Isolation for Gene Expression Analysis in Critically Ill Hospitalized Patients. Clin. Chem.
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Byers, R. J., Sakhinia, E., Joseph, P., Glennie, C., Hoyland, J. A., Menasce, L. P., Radford, J. A., Illidge, T.
(2008). Clinical quantitation of immune signature in follicular lymphoma by RT-PCR-based gene expression profiling. Blood
111: 4764-4770
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Canellos, G. P.
(2008). What Constitutes "Improved Prognosis"?. JCO
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Le Page, C., Ouellet, V., Quinn, M. C.J., Tonin, P. N., Provencher, D. M., Mes-Masson, A.-M.
(2008). BTF4/BTNA3.2 and GCS as Candidate mRNA Prognostic Markers in Epithelial Ovarian Cancer. Cancer Epidemiol. Biomarkers Prev.
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Jacob, J., Jentsch, M., Kostka, D., Bentink, S., Spang, R.
(2008). Detecting hierarchical structure in molecular characteristics of disease using transitive approximations of directed graphs. Bioinformatics
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Jardin, F., Ruminy, P., Kerckaert, J.-P., Parmentier, F., Picquenot, J.-M., Quief, S., Villenet, C., Buchonnet, G., Tosi, M., Frebourg, T., Bastard, C., Tilly, H.
(2008). Detection of somatic quantitative genetic alterations by multiplex polymerase chain reaction for the prediction of outcome in diffuse large B-cell lymphomas. haematol
93: 543-550
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Lam, L. T., Wright, G., Davis, R. E., Lenz, G., Farinha, P., Dang, L., Chan, J. W., Rosenwald, A., Gascoyne, R. D., Staudt, L. M.
(2008). Cooperative signaling through the signal transducer and activator of transcription 3 and nuclear factor-{kappa}B pathways in subtypes of diffuse large B-cell lymphoma. Blood
111: 3701-3713
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Lenz, G., Davis, R. E., Ngo, V. N., Lam, L., George, T. C., Wright, G. W., Dave, S. S., Zhao, H., Xu, W., Rosenwald, A., Ott, G., Muller-Hermelink, H. K., Gascoyne, R. D., Connors, J. M., Rimsza, L. M., Campo, E., Jaffe, E. S., Delabie, J., Smeland, E. B., Fisher, R. I., Chan, W. C., Staudt, L. M.
(2008). Oncogenic CARD11 Mutations in Human Diffuse Large B Cell Lymphoma. Science
319: 1676-1679
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Tun, H. W., Personett, D., Baskerville, K. A., Menke, D. M., Jaeckle, K. A., Kreinest, P., Edenfield, B., Zubair, A. C., O'Neill, B. P., Lai, W. R., Park, P. J., McKinney, M.
(2008). Pathway analysis of primary central nervous system lymphoma. Blood
111: 3200-3210
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Roubenoff, R., Beckman, E., Weinblatt, M., Shadick, N., Gregersen, P. K.
(2008). Biological Significance of Anti-Cyclic Citrullinated Peptide Antibody in Rheumatoid Arthritis. ANN INTERN MED
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Brown, P. J., Ashe, S. L., Leich, E., Burek, C., Barrans, S., Fenton, J. A., Jack, A. S., Pulford, K., Rosenwald, A., Banham, A. H.
(2008). Potentially oncogenic B-cell activation-induced smaller isoforms of FOXP1 are highly expressed in the activated B cell-like subtype of DLBCL. Blood
111: 2816-2824
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Raponi, M., Lancet, J. E., Fan, H., Dossey, L., Lee, G., Gojo, I., Feldman, E. J., Gotlib, J., Morris, L. E., Greenberg, P. L., Wright, J. J., Harousseau, J.-L., Lowenberg, B., Stone, R. M., De Porre, P., Wang, Y., Karp, J. E.
(2008). A 2-gene classifier for predicting response to the farnesyltransferase inhibitor tipifarnib in acute myeloid leukemia. Blood
111: 2589-2596
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Ding, B. B., Yu, J. J., Yu, R. Y.-L., Mendez, L. M., Shaknovich, R., Zhang, Y., Cattoretti, G., Ye, B. H.
(2008). Constitutively activated STAT3 promotes cell proliferation and survival in the activated B-cell subtype of diffuse large B-cell lymphomas. Blood
111: 1515-1523
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Natkunam, Y., Farinha, P., Hsi, E. D., Hans, C. P., Tibshirani, R., Sehn, L. H., Connors, J. M., Gratzinger, D., Rosado, M., Zhao, S., Pohlman, B., Wongchaowart, N., Bast, M., Avigdor, A., Schiby, G., Nagler, A., Byrne, G. E., Levy, R., Gascoyne, R. D., Lossos, I. S.
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