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MYC and BCL 2 protein expression predicts survival in patients with diffuse large B ‐cell lymphoma treated with rituximab
Author(s) -
Perry Anamarija M.,
AlvaradoBernal Yuridia,
Laurini Javier A.,
Smith Lynette M.,
Slack Graham W.,
Tan King L.,
Sehn Laurie H.,
Fu Kai,
Aoun Patricia,
Greiner Timothy C.,
Chan Wing C.,
Bierman Philip J.,
Bociek Robert G.,
Armitage James O.,
Vose Julie M.,
Gascoyne Randy D.,
Weisenburger Dennis D.
Publication year - 2014
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.12763
Subject(s) - diffuse large b cell lymphoma , vincristine , rituximab , lymphoma , medicine , chop , oncology , cyclophosphamide , prednisone , survival analysis , cancer research , immunology , chemotherapy
Summary Diffuse large B ‐cell lymphoma ( DLBCL ) is a heterogeneous disease and “double‐hit” DLBCL , with both MYC and BCL 2 translocations has a poor prognosis. In this study, we investigated whether MYC and BCL 2 protein expression in tissue would predict survival in DLBCL . The study included 106 cases of de novo DLBCL treated with rituximab and cyclophosphamide, doxorubicin, vincristine and prednisone (R‐ CHOP ) or CHOP ‐like regimens. The results were validated on an independent cohort of 205 DLBCL patients. Patients with low expression of BCL 2 (≤30%) and MYC (≤50%) had the best prognosis, whereas those with high BCL 2 (>30%) and MYC (>50%) had the worst outcome. In multivariate analysis, the combination of the BCL 2 and MYC was an independent predictor of overall survival ( OS ) and event‐free survival ( EFS ) ( P = 0·015 and P = 0·005, respectively). The risk of death was nine times greater for patients with high BCL 2 and MYC compared to those with low expression. High BCL 2 and MYC was a strong predictor of poor OS ( P < 0·001) and EFS ( P = 0·0017) in patients with the germinal centre B ‐cell ( GCB ) type, but not in the non‐ GCB type. In DLBCL , high co‐expression of MYC and BCL 2 was an independent predictor of poor survival, and could be used to stratify patients for risk‐adapted therapies.