Prognostic significance of CXCR4 and mTOR expression in diffuse large B-cell lymphoma patients

Background: The aim of this study was to investigate the prognostic role of mammalian target of Rapamycin (mTOR) and C-X-C chemokine receptor type 4 (CXCR4) in diffuse large-B-cell lymphoma (DLBCL) patients. Patients and methods: This retrospective study was collected data from 64 de novo DLBCL patients, who received standardized R-CHOP therapy at two oncology centers. CXCR4 and mTOR expressions were assessed by immunohistochemistry. Results: Out of the 64 DLBCL patients, 40 patients were positive for CXCR4 (62.5%) and 35 patients for mTOR (54.7%) expressions. CXCR4 expression was positively correlated with mTOR expression (r = 0.7; p < .001). While mTOR expression was significantly associated with high lactate dehydrogenase level ( p = .03) and number of extranodal sites one or more ( p =.02), CXCR4 expression was significantly associated with high IPI score ( p < .001) and ECOG PS ( p = .005). Furthermore, the expression levels of mTOR and CXCR4 were significantly associated with older ages and poor response to treatment ( p = .04, <.001 and .04, .03, respectively). After a median Follow up of 22 months, mean ± SD overall survival (OS) was 65.391 ± 4.705. Kaplan–Meier analysis showed that patients positive for mTOR and CXCR4 expression had shorter DFS ( p = .01 & .02) and OS ( p = .02 & .04). Multivariate analysis showed that CXCR4 and mTOR positivity is an independent prognostic factor for significantly poorer DFS ( p = .03, and .02 respectively) but not for OS ( p = .09 and .08 respectively) in the DLBCL pateints. Conclusion: Our results indicate that the expression of CXCR4 and mTOR may be poor prognostic biomarkers in DLBCL.