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Objective: We aimed to investigate the effects of immunohistochemical and molecular presence of double hit lymphoma (DHL) (combined expression of myc and bcl-2) on overall and progression-free survival rates of patients with extranodal diffuse large B-cell lymphoma (DLBCL). Patients and Methods: A total of 31 patients (17 female, 14 male; mean age 57 years) with diagnosis of extranodal DLBCL were included into the study (patients in the 2008-2013 period, Karadeniz Technical University Medical School). In a retrospective manner, patient characteristics were noted [age at diagnosis, sex, sites of extranodal involvement, stage, high-risk group, histopathological diagnosis, International Prognostic Index (IPI) score, lactat dehydrogenase (LDH) level at diagnosis, bone marrow involvement, and treatment modalities]. Histopathological specimens underwent immunohistochemical (bcl-6, bcl-2, myc, CD10, Mum-1) and molecular (bcl-2 and myc, by means of PCR) analysis. Results: DHL was observed immunohistochemically in only one patient, while molecular studies found six cases. The sensitivity of PCR to detect bcl-2 and myc expressions wase 33% and 95% and the specificity was 80% and 91%, respectively. There was a correlation between myc and bcl-2 titers. Three-month overall survival rates were 50% and 88% in DHL positive and negative groups, respectively. Six-month overall survival rates were 16% and 76% in DHL positive and negative groups, respectively. Progression-free 3-month survival rates were 51% and 88% in DHL positive and negative groups, respectively. Progression-free 6-month survival rates were 33% and 76% in DHL positive and negative groups, respectively. Overall and progression free survival was short regardless of histopathological type of germinal and non-germinal center B cell lymphoma (p< 0.05, p< 0.001). Conclusion: We conclude that DHL presence in patients with extranodal DLBCL was an independent factor leading to shortened overall or progression-free survival. The molecular method is more specific and sensitive than immınohistochemical evaluation to identify DHL, and therefore it may be important while planning the treatment of patients.

türkiye'de lösemi lenfoma miyelom araştırmaları

Ekstranodal Diffüz Büyük B Hücreli Lenfomada Bcl-2 ve Myc Ekspresyon Birlikteliğinin Tedavi Yanıtı ve Prognoza Etkisinin Geriye Dönük Olarak Değerlendirilmesi