COO and MYC/BCL2 status do not predict outcome among patients with stage I/II DLBCL: a retrospective multicenter study

Allison Barraclough, Musa Alzahrani, Marianne Schmidt Ettrup, Mark Bishton, Chris van Vliet, Pedro Farinha, Clare Gould, Simone Birch, Laurie H. Sehn, Vishakha Sovani, Mitchell Steven Ward, Bradley Augustson, Jorne Biccler, Joseph M. Connors, David W. Scott, Maher K. Gandhi, Kerry J. Savage, Tarec El-Galaly, Diego Villa, Chan Yoon Cheah

Research output: Contribution to journalArticle

Abstract

In advanced-stage diffuse large B-cell lymphoma (DLBCL), the presence of an activated B-cell phenotype or a non-germinal center (GCB) phenotype, coexpression of MYC and BCL2 by immunohistochemistry, and the cooccurrence of MYC and BCL2 or BCL6 rearrangements are associated with inferior outcomes. It is unclear whether these variables remain prognostic in stage I/II patients. In this retrospective study, we evaluated the prognostic impact of cell of origin (COO), as well as dual-expressor (DE) status and molecular double-hit (DH) status, in stage I/II DLBCL by positron emission tomography with computed tomography (PET-CT). A total of 211 patients treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)-like regimens, with or without radiotherapy, was included. The median follow-up in the entire cohort was 4 years (range, 0.4-9.4), with estimated 4-year progression-free survival (PFS) and overall survival (OS) rates of 85% (95% confidence interval [CI], 79-89) and 88% (95% CI, 83-92), respectively. By univariable analysis, DE (PFS: hazard ratio [HR], 1.27; 95% CI, 0.58-2.81, P = .55 and OS: HR, 1.40; 95% CI, 0.60-3.30; P = .44), DH (PFS: HR, 1.21; 95% CI, 0.27-5.31; P = .80 and OS: HR, 0.61; 95% CI, 0.08-4.73; P = .64), and non-GCB status (PFS: HR, 1.59; 95% CI, 0.83-3.03; P= .16 and OS: HR, 1.80; 95% CI, 0.89-3.67; P = .10) were associated with poorer outcomes. In patients with PET-CT-defined stage I/II DLBCL treated with R-CHOP-like therapy, with or without radiation, COO and DE and DH status were not significantly associated with inferior PFS or OS.

Original languageEnglish
Pages (from-to)2013-2021
Number of pages9
JournalBlood advances
Volume3
Issue number13
DOIs
Publication statusPublished - 9 Jul 2019

Cite this

Barraclough, Allison ; Alzahrani, Musa ; Ettrup, Marianne Schmidt ; Bishton, Mark ; van Vliet, Chris ; Farinha, Pedro ; Gould, Clare ; Birch, Simone ; Sehn, Laurie H. ; Sovani, Vishakha ; Ward, Mitchell Steven ; Augustson, Bradley ; Biccler, Jorne ; Connors, Joseph M. ; Scott, David W. ; Gandhi, Maher K. ; Savage, Kerry J. ; El-Galaly, Tarec ; Villa, Diego ; Cheah, Chan Yoon. / COO and MYC/BCL2 status do not predict outcome among patients with stage I/II DLBCL : a retrospective multicenter study. In: Blood advances. 2019 ; Vol. 3, No. 13. pp. 2013-2021.
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title = "COO and MYC/BCL2 status do not predict outcome among patients with stage I/II DLBCL: a retrospective multicenter study",
abstract = "In advanced-stage diffuse large B-cell lymphoma (DLBCL), the presence of an activated B-cell phenotype or a non-germinal center (GCB) phenotype, coexpression of MYC and BCL2 by immunohistochemistry, and the cooccurrence of MYC and BCL2 or BCL6 rearrangements are associated with inferior outcomes. It is unclear whether these variables remain prognostic in stage I/II patients. In this retrospective study, we evaluated the prognostic impact of cell of origin (COO), as well as dual-expressor (DE) status and molecular double-hit (DH) status, in stage I/II DLBCL by positron emission tomography with computed tomography (PET-CT). A total of 211 patients treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)-like regimens, with or without radiotherapy, was included. The median follow-up in the entire cohort was 4 years (range, 0.4-9.4), with estimated 4-year progression-free survival (PFS) and overall survival (OS) rates of 85{\%} (95{\%} confidence interval [CI], 79-89) and 88{\%} (95{\%} CI, 83-92), respectively. By univariable analysis, DE (PFS: hazard ratio [HR], 1.27; 95{\%} CI, 0.58-2.81, P = .55 and OS: HR, 1.40; 95{\%} CI, 0.60-3.30; P = .44), DH (PFS: HR, 1.21; 95{\%} CI, 0.27-5.31; P = .80 and OS: HR, 0.61; 95{\%} CI, 0.08-4.73; P = .64), and non-GCB status (PFS: HR, 1.59; 95{\%} CI, 0.83-3.03; P= .16 and OS: HR, 1.80; 95{\%} CI, 0.89-3.67; P = .10) were associated with poorer outcomes. In patients with PET-CT-defined stage I/II DLBCL treated with R-CHOP-like therapy, with or without radiation, COO and DE and DH status were not significantly associated with inferior PFS or OS.",
keywords = "B-CELL LYMPHOMA, DOUBLE-HIT LYMPHOMA, GENE-EXPRESSION, PROGNOSTIC IMPACT, CLASSIFICATION, ORIGIN, IMMUNOHISTOCHEMISTRY, SURVIVAL, BCL2, MYC",
author = "Allison Barraclough and Musa Alzahrani and Ettrup, {Marianne Schmidt} and Mark Bishton and {van Vliet}, Chris and Pedro Farinha and Clare Gould and Simone Birch and Sehn, {Laurie H.} and Vishakha Sovani and Ward, {Mitchell Steven} and Bradley Augustson and Jorne Biccler and Connors, {Joseph M.} and Scott, {David W.} and Gandhi, {Maher K.} and Savage, {Kerry J.} and Tarec El-Galaly and Diego Villa and Cheah, {Chan Yoon}",
year = "2019",
month = "7",
day = "9",
doi = "10.1182/bloodadvances.2019000251",
language = "English",
volume = "3",
pages = "2013--2021",
journal = "Blood advances",
issn = "2473-9529",
publisher = "American Society of Hematology",
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Barraclough, A, Alzahrani, M, Ettrup, MS, Bishton, M, van Vliet, C, Farinha, P, Gould, C, Birch, S, Sehn, LH, Sovani, V, Ward, MS, Augustson, B, Biccler, J, Connors, JM, Scott, DW, Gandhi, MK, Savage, KJ, El-Galaly, T, Villa, D & Cheah, CY 2019, 'COO and MYC/BCL2 status do not predict outcome among patients with stage I/II DLBCL: a retrospective multicenter study' Blood advances, vol. 3, no. 13, pp. 2013-2021. https://doi.org/10.1182/bloodadvances.2019000251

COO and MYC/BCL2 status do not predict outcome among patients with stage I/II DLBCL : a retrospective multicenter study. / Barraclough, Allison; Alzahrani, Musa; Ettrup, Marianne Schmidt; Bishton, Mark; van Vliet, Chris; Farinha, Pedro; Gould, Clare; Birch, Simone; Sehn, Laurie H.; Sovani, Vishakha; Ward, Mitchell Steven; Augustson, Bradley; Biccler, Jorne; Connors, Joseph M.; Scott, David W.; Gandhi, Maher K.; Savage, Kerry J.; El-Galaly, Tarec; Villa, Diego; Cheah, Chan Yoon.

In: Blood advances, Vol. 3, No. 13, 09.07.2019, p. 2013-2021.

Research output: Contribution to journalArticle

TY - JOUR

T1 - COO and MYC/BCL2 status do not predict outcome among patients with stage I/II DLBCL

T2 - a retrospective multicenter study

AU - Barraclough, Allison

AU - Alzahrani, Musa

AU - Ettrup, Marianne Schmidt

AU - Bishton, Mark

AU - van Vliet, Chris

AU - Farinha, Pedro

AU - Gould, Clare

AU - Birch, Simone

AU - Sehn, Laurie H.

AU - Sovani, Vishakha

AU - Ward, Mitchell Steven

AU - Augustson, Bradley

AU - Biccler, Jorne

AU - Connors, Joseph M.

AU - Scott, David W.

AU - Gandhi, Maher K.

AU - Savage, Kerry J.

AU - El-Galaly, Tarec

AU - Villa, Diego

AU - Cheah, Chan Yoon

PY - 2019/7/9

Y1 - 2019/7/9

N2 - In advanced-stage diffuse large B-cell lymphoma (DLBCL), the presence of an activated B-cell phenotype or a non-germinal center (GCB) phenotype, coexpression of MYC and BCL2 by immunohistochemistry, and the cooccurrence of MYC and BCL2 or BCL6 rearrangements are associated with inferior outcomes. It is unclear whether these variables remain prognostic in stage I/II patients. In this retrospective study, we evaluated the prognostic impact of cell of origin (COO), as well as dual-expressor (DE) status and molecular double-hit (DH) status, in stage I/II DLBCL by positron emission tomography with computed tomography (PET-CT). A total of 211 patients treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)-like regimens, with or without radiotherapy, was included. The median follow-up in the entire cohort was 4 years (range, 0.4-9.4), with estimated 4-year progression-free survival (PFS) and overall survival (OS) rates of 85% (95% confidence interval [CI], 79-89) and 88% (95% CI, 83-92), respectively. By univariable analysis, DE (PFS: hazard ratio [HR], 1.27; 95% CI, 0.58-2.81, P = .55 and OS: HR, 1.40; 95% CI, 0.60-3.30; P = .44), DH (PFS: HR, 1.21; 95% CI, 0.27-5.31; P = .80 and OS: HR, 0.61; 95% CI, 0.08-4.73; P = .64), and non-GCB status (PFS: HR, 1.59; 95% CI, 0.83-3.03; P= .16 and OS: HR, 1.80; 95% CI, 0.89-3.67; P = .10) were associated with poorer outcomes. In patients with PET-CT-defined stage I/II DLBCL treated with R-CHOP-like therapy, with or without radiation, COO and DE and DH status were not significantly associated with inferior PFS or OS.

AB - In advanced-stage diffuse large B-cell lymphoma (DLBCL), the presence of an activated B-cell phenotype or a non-germinal center (GCB) phenotype, coexpression of MYC and BCL2 by immunohistochemistry, and the cooccurrence of MYC and BCL2 or BCL6 rearrangements are associated with inferior outcomes. It is unclear whether these variables remain prognostic in stage I/II patients. In this retrospective study, we evaluated the prognostic impact of cell of origin (COO), as well as dual-expressor (DE) status and molecular double-hit (DH) status, in stage I/II DLBCL by positron emission tomography with computed tomography (PET-CT). A total of 211 patients treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)-like regimens, with or without radiotherapy, was included. The median follow-up in the entire cohort was 4 years (range, 0.4-9.4), with estimated 4-year progression-free survival (PFS) and overall survival (OS) rates of 85% (95% confidence interval [CI], 79-89) and 88% (95% CI, 83-92), respectively. By univariable analysis, DE (PFS: hazard ratio [HR], 1.27; 95% CI, 0.58-2.81, P = .55 and OS: HR, 1.40; 95% CI, 0.60-3.30; P = .44), DH (PFS: HR, 1.21; 95% CI, 0.27-5.31; P = .80 and OS: HR, 0.61; 95% CI, 0.08-4.73; P = .64), and non-GCB status (PFS: HR, 1.59; 95% CI, 0.83-3.03; P= .16 and OS: HR, 1.80; 95% CI, 0.89-3.67; P = .10) were associated with poorer outcomes. In patients with PET-CT-defined stage I/II DLBCL treated with R-CHOP-like therapy, with or without radiation, COO and DE and DH status were not significantly associated with inferior PFS or OS.

KW - B-CELL LYMPHOMA

KW - DOUBLE-HIT LYMPHOMA

KW - GENE-EXPRESSION

KW - PROGNOSTIC IMPACT

KW - CLASSIFICATION

KW - ORIGIN

KW - IMMUNOHISTOCHEMISTRY

KW - SURVIVAL

KW - BCL2

KW - MYC

U2 - 10.1182/bloodadvances.2019000251

DO - 10.1182/bloodadvances.2019000251

M3 - Article

VL - 3

SP - 2013

EP - 2021

JO - Blood advances

JF - Blood advances

SN - 2473-9529

IS - 13

ER -