Clinical Implications of CD30 Expression in Aggressive B-Cell Lymphomas

US Food and Drug Administration approval of brentuximab for treatment of CD30-positive relapsed/refractory lymphomas initiated research focused on CD30 expression in lymphomas. We studied CD30 expression in various types of previously unstudied aggressive B-cell lymphomas, including Burkitt lymphoma, high-grade follicular lymphoma, grade III follicular lymphoma/diffuse large B-cell lymphoma (DLBCL), DLBCL type posttransplantation lymphoproliferative disease, and primary mediastinal B-cell lymphoma. Background US Food and Drug Administration approval of brentuximab vedotin for treatment of CD30-positive relapsed/refractory lymphomas, including classical Hodgkin lymphoma and anaplastic large cell lymphoma, initiated significant interest in researching CD30 expression in other therapy-resistant or relapsed lymphomas. We evaluated CD30 expression in 116 cases of aggressive B-cell lymphomas diagnosed at Penn State Milton S. Hershey Medical Center between 2000 and 2012 with the purpose of assessing the benefit of treatment with brentuximab. Patients and Methods We studied CD30 expression in types of aggressive B-cell lymphomas not previously studied, including Burkitt lymphoma, high-grade (grade III) follicular lymphoma, mixed grade III follicular lymphoma/diffuse large B-cell lymphoma (DLBCL), posttransplantation lymphoproliferative disease large B-cell lymphoma, and primary mediastinal large B-cell lymphoma. Results CD30 expression was found in 37.5% of DLBCL and 46.2% of other non-DLBCL aggressive B-cell lymphomas. Conclusion Expression of CD30 in patients with both DLBCL and other aggressive B-cell lymphomas and the absence of MYC oncogene–driven proliferation in the majority of these tumors suggests that brentuximab may be a particularly effective form of targeted therapy in the subset of patients with high CD30 expression.