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
C2 - 31285189
SN - 2473-9529
VL - 3
SP - 2013
EP - 2021
JO - Blood advances
JF - Blood advances
IS - 13
ER -