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"Diffuse large B-cell lymphoma (DLBCL) merupakan limfoma jenis sel B tersering pada kasus limfoma non-Hodgkin dan bersifat agresif, sehingga dibutuhkan diagnosis dan terapi yang cepat dan tepat. Terdapat beberapa kriteria prognosis untuk pasien DLBCL salah satunya klasifikasi Hans. Berdasarkan klasifikasi Hans, DLBCL dibagi menjadi subtipe Germinal Center B-cell-like (GCB) dan Non-Germinal Center B-cell-like (non-GCB). Beberapa pasien tidak menunjukkan respons yang baik terhadap terapi kombinasi dengan rituximab (R-CHOP). Para peneliti sedang mencari pengobatan terbaru DLBCL yang sulit diobati atau sering kambuh. Salah satunya menggunakan imunoterapi anti-CTLA-4. Penelitian ini bertujuan untuk menilai ekspresi CTLA-4 pada DLBCL subtipe GCB dan non-GCB. Penelitian retrospektif analitik ini menggunakan 50 sampel blok parafin yang sebelumnya telah didiagnosis sebagai DLBCL subtipe GCB dan non-GCB yang tercatat di arsip Departeman Patologi Anatomik FKUI/RSCM. Rerata ekspresi CTLA-4 pada DLBCL ditemukan lebih banyak pada subtipe non-GCB (61,66 sel/lapang pandang besar) dibandingkan subtipe GCB (40,5 sel/lapang pandang besar) (p=0,076). Rerata ekspresi CTLA-4 lebih tinggi pada kelompok usia £ 60 tahun, perempuan, stadium penyakit III-IV, dan keterlibatan >1 lokasi ekstranodal. Rerata ekspresi CTLA-4 lebih tinggi pada kelompok skor IPI rendah (0-2) dibandingkan skor IPI tinggi (3-5). Tidak ditemukan perbedaan ekspresi CTLA-4 yang bermakna pada DLBCL subtipe GCB dan non-GCB, meskipun terdapat tren rerata ekspresi CTLA-4 yang lebih tinggi pada kelompok non-GCB.

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Diffuse large B-cell lymphoma (DLBCL) is the most common type of B-cell non-Hodgkin's lymphoma and is aggressive in nature, so prompt and appropriate diagnosis and treatment are needed. There are several prognostic criteria for DLBCL patients, one of which is the Hans classification. Based on Hans classification, DLBCL is divided into Germinal Center B-cell-like (GCB) and Non-Germinal Center B-cell-like (non-GCB) subtypes. Some patients do not respond well to combination therapy with rituximab (R-CHOP). Researchers are looking for new treatments for DLBCL that is difficult to treat or recurs frequently. One of them uses anti-CTLA-4 immunotherapy. This study aimed to assess the expression of CTLA-4 in GCB and non-GCB DLBCL subtypes. This analytic retrospective study used 50 samples of paraffin blocks previously diagnosed as GCB and non-GCB subtype DLBCL recorded in the archives of the Department of Anatomic Pathology FKUI/RSCM. The average CTLA-4 expression in DLBCL was found to be higher in the non-GCB subtype (61.66 cells/high power field) than the GCB subtype (40.5 cells/high power field) (p=0.076). The average CTLA-4 expression was higher in the age group 60 years, women, stage III-IV disease, and involvement of >1 extranodal site. The average CTLA-4 expression was higher in the low IPI score group (0-2) than in the high IPI score group (3-5). There was no significant difference in CTLA-4 expression in GCB and non-GCB DLBCL subtypes, although there was a trend of higher mean CTLA-4 expression in the non-GCB group.

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"Background: graves disease (GD) is the most common condition of thyrotoxicosis. The management of GD is initiated with the administration of antithyroid drugs; however, it requires a long time to achieve remission. In reality more than 50% of patients who had remission may be at risk for relapse after the drug is stopped. This study aimed to evaluate the role of clinical factors such as smoking habit, degree of ophtalmopathy, degree of thyroid enlargement; genetic factors such as CTLA 4 gene on nucleotide 49 at codon 17 of exon 1, CTLA 4 gene of promotor -318, TSHR gene polymorphism rs2268458 of intron 1; and immunological factors such as regulatory T cells (Treg) and thyroid receptor antibody (TRAb); that affecting the relapse of patients with Graves disease in Indonesia. Methods: this was a case control study, that compared 72 subjects who had relapse and 72 subjects without relapse at 12 months after cessation of antithyroid treatment, who met the inclusion criteria. Genetic polymorphism examination was performed using PCR-RFLP. The number of regulatory T cells was counted using flow cytometry analysis and ELISA was used to measure TRAb. The logistic regression was used since the dependent variables were categorical variables. Results: the analysis of this study demonstrated that there was a correlation between relapse of disease and family factors (p=0.008), age at diagnosis (p=0.021), 2nd degree of Graves ophthalmopathy (p=0.001), enlarged thyroid gland, which exceeded the lateral edge of the sternocleidomastoid muscles (p=0.040), duration of remission period (p=0.029), GG genotype of CTLA 4 gene on the nucleotide 49 at codon 17 of exon 1 (p=0.016), CC genotype of TSHR gene on the rs2268458 of intron 1 (p=0.003), the number of regulatory T cells (p=0.001) and TRAb levels (p=0.002). Conclusion: genetic polymorphisms of CTLA 4 gene on the nucleotide 49 at codon 17 of exon 1, TSHR gene SNP rs2268458 of intron 1, number of regulatory T cells and TRAb levels play a role as risk factors for relapse in patients with Graves disease."