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Prognostic significance of the Ki-67-associated proliferative antigen in
aggressive non-Hodgkin's lymphomas: a prospective Southwest Oncology Group
trial
TP Miller, TM Grogan, S Dahlberg, CM Spier, RM Braziel, PM Banks, K Foucar, CR Kjeldsberg, N Levy and BN Nathwani
University of Arizona, Tucson.
The growth fraction of tumors from patients with non-Hodgkin's lymphomas
(NHL) has been shown to correlate with survival in retrospective studies.
The growth fraction can be evaluated using immunohistochemical techniques
employing the Ki-67 monoclonal antibody (MoAb) that marks a nuclear protein
present in cycling cells. The purpose of this study was to evaluate the
clinical utility of the Ki-67 MoAb for predicting survival. Using a
prospective trial design in a multi-institutional cooperative trials group,
the proliferative index, clinical outcome, and statistical correlations
were independently assessed for previously untreated patients with advanced
stages of intermediate- and high-grade histologies of NHL treated on
Southwest Oncology Group study (SWOG 8516, Intergroup 0067). The proportion
of Ki- 67-positive cells was determined on snap-frozen thin tissue
sections. A proliferative index of 80% or greater, as determined from prior
retrospective studies, identified a group of patients (18%) who had a poor
outcome. Overall survival was significantly reduced in these patients with
a high Ki-67-associated proliferative index compared with those with a low
proliferative index (P = .001). One-year survival estimates were 82% (low
proliferative index) versus 18% (high proliferative index). A multivariate
regression analysis incorporating commonly used clinical prognostic
features confirmed the independent effect of proliferation on survival
(relative risk estimate 5.9; 95% confidence interval, 2.2, 16.1). The Ki-67
MoAb identifies a group of patients with rapidly fatal NHL for whom
currently available chemotherapy is inadequate.
Volume 83,
Issue 6,
pp. 1460-1466,
03/15/1994
Copyright © 1994 by The American Society of Hematology
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