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Sole rearrangement but not amplification of MYC is associated with a poor prognosis in patients with diffuse large B cell lymphoma and B cell lymphoma unclassifiable
Author(s) -
Landsburg Daniel J.,
Falkiewicz Marissa K.,
Petrich Adam M.,
Chu Benjamin A.,
Behdad Amir,
Li Shaoying,
Medeiros L. Jeffrey,
Cassaday Ryan D.,
Reddy Nishitha M.,
Bast Martin A.,
Vose Julie M.,
Kruczek Kimberly R.,
Smith Scott E.,
Patel Priyank,
HernandezIlizaliturri Francisco,
Karmali Reem,
Rajguru Saurabh,
Yang David T.,
Maly Joseph J.,
Blum Kristie A.,
Zhao Weiqiang,
Vanslambrouck Charles,
Nabhan Chadi
Publication year - 2016
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.14282
Subject(s) - vincristine , lymphoma , medicine , diffuse large b cell lymphoma , rituximab , gene rearrangement , chop , bcl6 , gastroenterology , cyclophosphamide , prednisone , oncology , cancer research , chemotherapy , b cell , immunology , biology , antibody , biochemistry , gene , germinal center
Summary Rearrangement of MYC is associated with a poor prognosis in patients with diffuse large B cell lymphoma ( DLBCL ) and B cell lymphoma unclassifiable ( BCLU ), particularly in the setting of double hit lymphoma ( DHL ). However, little is known about outcomes of patients who demonstrate MYC rearrangement without evidence of BCL 2 or BCL 6 rearrangement (single hit) or amplification (>4 copies) of MYC . We identified 87 patients with single hit lymphoma ( SHL ), 22 patients with MYC ‐amplified lymphoma ( MYC amp) as well as 127 DLBCL patients without MYC rearrangement or amplification ( MYC normal) and 45 patients with DHL , all treated with either R‐ CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) or intensive induction therapy. For SHL and MYC amp patients, the 2‐year progression‐free survival rate ( PFS ) was 49% and 48% and 2‐year overall survival rate ( OS ) was 59% and 71%, respectively. SHL patients receiving intensive induction experienced higher 2‐year PFS (59% vs. 23%, P = 0·006) but similar 2‐year OS as compared with SHL patients receiving R‐ CHOP . SHL DLBCL patients treated with R‐ CHOP , but not intensive induction, experienced significantly lower 2‐year PFS and OS ( P < 0·001 for both) when compared with MYC normal patients. SHL patients appear to have a poor prognosis, which may be improved with receipt of intensive induction.