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24 protocols using bcl2 clone 124

1

Immunohistochemical Profiling of Lymphoma

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Immunohistochemical stainings were performed on FFPE tissue using fully automated protocols (DAKO Autostainer Link 48). Staining protocols with antibodies to MYC (clone Y69; Abcam), BCL‐2 (clone 124; DAKO), BCL‐6 (clone PG‐B6p; DAKO), Ki‐67 (MIB‐1; DAKO), MUM‐1(clone MUM1p; DAKO), CD10 (clone 56C6; DAKO) and p53 (DO‐7; DAKO) were performed. The estimation of positive staining for CD10, BCL‐6 and MUM‐1 was based on the Hans algorithm. Cut‐off values of 70% and 40% were used for BCL2 and MYC, respectively, as previously described.16
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2

Western Blot Analysis of Cellular Proteins

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Whole cell protein extracts were obtained by lysing 2–5 × 106 cells with Laemmli sample buffer. Protein concentration was measured with the Micro BCATM Protein Assay Reagent kit (Thermo Scientific Pierce, Rockford, IL, USA). Protein extracts (25 μg) were subjected to reducing conditions before being subjected to electrophoresis on a polyacrylamide gel and then transferred to Immobilon-P membranes (Millipore, Billerica, MA, USA). One hour after blocking with 5% (w/v) non-fat milk in Tris-buffered saline with 0.1% Tween®-20, the membranes were incubated with the specific primary antibodies against BCL-2 (clone 124, #M0887, Dako, Denmark), BIM (clone C34C5, #2933, Cell Signaling, Danvers, MA, USA), cleaved caspase 3 (#9661, Cell Signaling), ERK2 (clone 1B3B9, #05-157, Millipore, Temecula, CA, USA), NOXA (clone 114C307, #ab13654, Abcam, Cambridge, UK), MCL-1 (clone S-19, #sc-819, Santa Cruz Biotechnology, Dallas, TX, USA), PHB1 (clone H-80, #sc-28259, Santa Cruz Biotechnology), PHB2 (anti-REA, #07-234, Millipore), PARP (#9542, Cell Signaling), PUMA (#4976, Cell Signaling), β-Actin (clone AC-15, #A5441, Sigma-Aldrich) and Tubulin (clone Ab-1, #CP06, Oncogene, Darmstadt, Germany). Antibody binding was detected using a secondary antibody conjugated to horseradish peroxidase and the enhanced chemiluminescence (ECL) detection system (GE Healthcare, Amersham Place, Buckinghamshire, UK).
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3

Immunohistochemical Profiling of Lymphoma

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Immunohistochemistry (IHC) was performed using antibodies against MYC (clone EP121, Cell Marque, Rocklin, CA, USA), BCL2 (clone 124, DAKO, Carpinteria, CA, USA), BCL6 (clone LN22, Novocastra, Newcastle, United Kingdom), CD10 (clone 56C6, Novocastra), and MUM1 (clone Ma695, Novocastra). IHC staining was performed using the Ventana Benchmark XT system (Ventana Medical Systems, Tucson, AZ, USA) or a Bond-Max automated immunostainer (Leica Microsystems, Melbourne, Australia). Cell of origin was assessed according to the Hans criteria [11 (link)]. IHC score was determined to be the percentage of tumor cells with robust immunostaining evaluated by 10 % increments. Cutoff values (i.e. IHC scores) of ≥40 % for MYC, ≥30 and ≥60 % for BCL2 and ≥50 % for BCL6 were determined to have discriminant prognostic power based on the receiver operator characteristic (ROC) curves and were thus used for classifying cases into MYC-, BCL2- or BCL6-negative and-positive groups.
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4

Immunohistochemistry Panel for Lymphoma

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Immunohistochemistry was performed on 4-μm FFPE sections. Antibodies used in the study were CD20 (clone L26, Abcam, cutoff: 30%), CD10 (clone 56C6, Dako, cutoff: 30%), MUM1 (clone MUM1p, Dako), Bcl6 (clone LN22, Dako, cutoff: 30%), Myc (clone Y69; Abcam, cutoff: 40%) and Bcl2 (clone 124; Dako, cutoff: 50%). Cutoff scores for each antibody were described previously [2 (link), 19 (link)].
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5

Immunohistochemical Evaluation of Bcl2 and Bax

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Sections from formalin-fixed specimens embedded in paraffin were attached on positively charged slides then autoclaved at 58°C for 24 h. Deparaffinized and rehydrated sections were engrossed in 10 mL/L H2O2 for 20 min, and then they were washed 3 times, each time for 3 min with PBS. Sections were preincubated with 10 mL/L normal goat anti-rabbit serum for 20 min at RT and then were incubated with the antibodies diluted for 18 h at 4°C and Envision reagent for 30 min at 37°C. Sections were stained by 0.4 g/L DAB with 0.3 mL/L H2O2 for 8 min and hematoxylin for 30 s. The results were observed under a light microscope. PBS instead of the primary antibody was used as the negative control.
Antibodies used were Bcl2 (clone 124, code no. M0887, IgG1, kappa; Dako, Glostrup, Denmark) and Bax (IgG; Oncogene Science, Inc, USA). Immunohistochemical staining assessment was achieved using a light microscopy (10× objective lens) with the selective use of a 20–40×objective lens for validation. Immunoreactivity interpretation was accomplished semantically by investigating the staining cytoplasmic positivity extent. Immunostaining of less than 10% of epithelial cells was scored +1; 10–50% positivity scored +2; 51–90% scored +3; while >90% positivity scored +4 [27 (link)].
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6

Immunohistochemical and FISH Analysis of DLBCL

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IHC was prospectively performed on the routine diagnostic basis using representative whole formalin-fixed paraffin-embedded (FFPE) tissue sections and antibodies against CD3 (clone 2GV6; Ventana Medical Systems, Tucson, AZ, USA), CD20 (clone L26; DAKO, Carpinteria, CA, USA), BCL2 (clone 124; DAKO, Carpinteria, CA, USA), BCL6 (clone LN22; Novocastra, Newcastle, UK), CD10 (clone 56C6; Novocastra), MUM1 (clone Ma695; Novocastra), MYC (clone EP121; Cell Marque, Rocklin, CA, USA), and Ki-67 (clone MIB-1; DAKO). Staining was performed using a Ventana Benchmark XT (Ventana Medical Systems) or a Bond-Max autostainer (Leica Microsystems, Melbourne, Australia). COO was determined using the IHC-based Hans algorithm as previously described [29 (link)]. DE status was defined as the co-expression of MYC (in ≥40% of tumor cells) and BCL2 (in ≥70% of tumor cells) as previously described [12 (link)]. TMA was constructed using the FFPE tissue blocks from 50 selected cases with DLBCL, and we performed MYC, BCL2, BCL6 FISH on the TMA. FISH was performed using Vysis LSI BCL2 Dual Color Break Apart Rearrangement Probe (Vysis, Downers Grove, IL, USA), Vysis LSI BCL6 Dual Color Break Apart Rearrangement Probe (Vysis), and Vysis LSI MYC Dual Color Break Apart Rearrangement Probe (Vysis)).
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7

Immunocytochemical Analysis of Malignant Cells

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Immunocytochemical analysis was possible only on CBs, on three micron-thick unstained sections. An initial panel of antibodies was used in malignant cases to differentiate lymphoma from carcinoma and sarcoma, namely pan-cytokeratin (clone AE1/3; DAKO, Carpinteria, CA, USA), CD45/LCA (Clones 2B11+PD7/26; DAKO), CD20 (clone L26; DAKO), CD79α (clone JCB 117; DAKO), CD3 (polyclonal; DAKO), EMA (clone E29; DAKO), CD30 (clone Ber-H2; DAKO), CD15 (clone Carb-3; DAKO) and PAX5 (clone DAK-PAX5; DAKO). In case a diagnosis of B-lineage NHL had been advanced, a second lineage of immunocytochemical markers was performed, including BCL2 (clone 124; DAKO), BCL6 (clone PG-B6p; DAKO), CD10 (clone 56C6; DAKO), CD5 (clone 4C7; DAKO), CyclinD1 (clone EP12; DAKO), MUM1/IRF4 (clone MUM1p; DAKO) and Mib1 (clone Ki67; DAKO). All staining procedures were carried out on Autostainer Link48 (DAKO, DAKO), according to the manufacturer’s instructions and in the presence of appropriate controls. Neither morphology nor first- nor second-line immunocytochemical analyses aroused suspicion of T-lineage NHL.
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8

Prognostic Biomarkers in Diffuse Large B-Cell Lymphoma

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Tissue microarrays prepared from the diagnostic formalin-fixed, paraffin-embedded (FFPE) tissue blocks of all patients studied were stained with an anti-p63 antibody (4A4, Santa Cruz Biotechnology, Santa Cruz, CA) which can detect all p63 isoforms. Expression levels of p63 were determined by estimating the percentage of p63-positive tumor cells in the tissue array cores. X-tile software and receiver operating characteristic curve analysis by GraphPad Prism 6 Software were used to determine the percentage of p63-positive cells with maximal discriminatory power for the separation of DLBCL patients into 2 different prognostic groups. Evaluation of other biomarkers by immunohistochemistry was also performed on tissue microarrays using corresponding antibodies: p53 (DO-7, Dako, Carpinteria, CA), MDM2 (IF2, Calbiochem, Billerica, MA), p21 (Dako), Bcl-2 (Clone-124, Dako, Carpinteria, CA), Ki-67 (Dako), CD30 (clone BerH2, Dako), Bcl-6 (Dako), FOXP1 (Abcam), IRF4/MUM1 (Dako), CD10 (56C6, Vantana), c-Rel (Dako), and CXCR4 (Abcam, San Francisco, CA). Details of immunohistochemistry procedures and scoring processes have been described previously [38 (link), 44 (link), 55 (link)–58 (link)].
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9

Molecular Profiling of Diffuse Large B-Cell Lymphoma

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Evaluation of genetic alterations and protein expression has been described previously (11 (link), 14 (link), 17 (link), 30 (link)–32 (link)). Formalin-fixed paraffin-embedded (FFPE) biopsies were organized prior to R-CHOP treatment and tissue microarray was constructed for study. IHC analysis was performed for the following markers with corresponding antibodies: MYC (clone Y69, Epitomics), BCL-2 (clone 124, DAKO), p53 (clone DO-7, DAKO), and Ki-67 (clone MIB-1, DAKO). The cut-off values were 40% for MYC, 50% for BCL-2, 30% for p53 (average of the two cutoffs in previous studies; refs. 14 (link), 17 (link)), and 70% for Ki-67 as previously determined.
FISH analysis was performed on FFPE sections to detect MYC rearrangement using a Vysis LSI MYC dual-color break-apart rearrangement probe (Abbott Molecular) following the manufacturer’s instructions. Images were captured and reviewed using Cytovision software (Applied Imaging). At least 200 tumor cell nuclei were scored and a cutoff of more than 5% of positive cells was used to determine the presence of MYC rearrangement.
TP53 mutations were detected using the AmpliChip p53 Research Test (Roche Molecular Systems), which is a microarray-based assay that detects mutations in exons 2–11 (14 (link)).
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10

Immunohistochemical Evaluation of Lymphoma Markers

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Immunohistochemistry (IHC) was performed with the Dako Autostainer Link 48, according to the manufacturer’s recommendations, for the antibodies CD10 (clone 56C6 from Dako, diluted 1:20), BCL6 (clone PG-B6p from Invitrogen, diluted 1:100), MUM1 (clone MUM1p from Dako, diluted 1:100), BCL2 (clone 124 Dako, diluted 1:80), and IgM (polyclonal, from Dako, diluted 1:500). The markers were scored positive in case of expression in ≥ 30% of the tumor cells for CD10, BCL6, and MUM1, and in ≥ 50% of the tumor cells for BCL2 and IgM.
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