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Impact of age in an unselected population of Diffuse large B-cell lymphomas
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Oncology.
Lunds Universitet.
Lunds Universitet.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Oncology.
2014 (English)Article in journal (Refereed) Submitted
Place, publisher, year, edition, pages
2014.
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:uu:diva-219351OAI: oai:DiVA.org:uu-219351DiVA: diva2:699376
Available from: 2014-02-27 Created: 2014-02-27 Last updated: 2014-06-05Bibliographically approved
In thesis
1. Prognostic Markers in Diffuse Large B-cell Lymphoma: How Bad can it be
Open this publication in new window or tab >>Prognostic Markers in Diffuse Large B-cell Lymphoma: How Bad can it be
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Diffuse large B-cell lymphoma (DLBCL), which is the most common type of lymphoma, is characterised by its aggressiveness and poor outcome without adequate treatment and also for its biological and clinical heterogeneity. It is therefore highly desirable to gain a more profound understanding of the underlying biology of the disease, as well as predictive factors for the guidance of treatment. The studies presented here attempt to gain an overall grasp on DLBCL, from the epidemiological level down to the genomic level.

The tumour microenvironment consists of both tumour cells and normal infiltrating cells in a delicate interplay. By assessing the number of infiltrating mast cells (MCs) in the microenvironment, a correlation between low numbers of MCs and poorer prognosis of DLBCL was found.

However, malignant cells are not only affected by environmental conditions but also by intrinsic factors, such as small non-coding microRNAs. A low expression level of microRNA-129 was found to correlate with poor survival of DLBCL and the finding remained significant even for rituximab-treated patients.

An even smaller intracellular genomic unit is one single nucleotide. The single nucleotide polymorphism 309 (SNP309) is a T to G change in the promotor region of MDM2, a regulatory protein in the p53 pathway, which results in increased transcription of MDM2 and thus decreased levels of p53. It was found that homozygous T allele patients had longer overall survival, as well as disease-specific survival and disease-free survival. However, treatment with rituximab eliminated the predictive value of the SNP309 polymorphism.

In the last project presented in this thesis we used epidemiological methods to analyse all DLBCL cases diagnosed 2000-2013 in Sweden. Here it was possible to categorically show that higher age is an adverse prognostic factor, and most importantly, this starts from a young age.

In conclusion, within this thesis I have applied different laboratory and analysis techniques to examine DLBCL biology in relation to the clinic. I have identified potential new prognostic markers, contributed to an enhanced understanding of DLBCL biology and described epidemiological data from one of the largest DLBCL cohorts ever presented. All of these aspects provide important information for a deeper understanding of the disease DLBCL. 

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2014. 85 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 978
Keyword
DLBCL, Survival, Mast cell, Microenvironment, MicroRNA, MDM2, Polymorphism, Age, Epidemiology
National Category
Cancer and Oncology
Research subject
Oncology
Identifiers
urn:nbn:se:uu:diva-220010 (URN)978-91-554-8896-3 (ISBN)
Public defence
2014-04-26, Auditorium Minus Gustavianum, Akademigatan 3, Uppsala, 09:15 (English)
Opponent
Supervisors
Available from: 2014-04-01 Created: 2014-03-09 Last updated: 2014-04-29

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Hedström, GustafEnblad, Gunilla

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