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Stratification by MYC expression has prognostic impact in MYC/BCL2 translocated B-cell lymphoma - identifies a subgroup of patients with poor outcome

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@article{c00ad715baec4b239677e5cf3d19976e,
title = "Stratification by MYC expression has prognostic impact in MYC/BCL2 translocated B-cell lymphoma - identifies a subgroup of patients with poor outcome",
abstract = "OBJECTIVE: In patients with Large B-cell Lymphoma (LBCL) according to WHO the prognostic significance of MYC translocation is still not sufficiently clarified. We therefore aimed to investigate whether prognostication could be improved in patients with MYC translocation positive LBCL by additional stratification according to MYC and BCL2 protein expression levels or MYC translocation partner gene as well as concurrent BCL2 and/or BCL6 translocation (DH).METHODS: From an unselected consecutive cohort of >600 patients with LBCL investigated with fluorescent in situ hybridization (FISH) 64 patients were diagnosed with MYC translocation positive LBCL and included in the study. They were further investigated for supplemental translocations with FISH and MYC and BCL2 protein expression with immunohistochemistry (IHC).RESULTS: MYC expression >75{\%} was associated with both reduced progression free survival (PFS) and overall survival (OS) (PFS: HR 6.8 (95{\%}CI 1.5-31), p=0.004. OS: HR 4.3 (95{\%}CI 0.9-21), p=0.05). Immunoglobulin (IG) MYC translocation partner gene was related to high MYC protein expression (p=0.047) but was not prognostic for PFS (p=0.8) or OS (p=0.6). DH did not confer a worse outcome compared to MYC single hit (SH). These findings were confirmed in a comparable, independent validation cohort of 28 patients with MYC translocation positive LBCL. All patients included in the survival analyses were treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) or R-CHOEP (R-CHOP+etoposide).CONCLUSION: These findings suggest that in patients with LBCL stratification by MYC protein expression level significantly improves the prognostic impact associated with MYC translocation. This article is protected by copyright. All rights reserved.",
author = "Pedersen, {Mette {\O}lgod} and Gang, {Anne Ortved} and Linde, {Erik Clasen} and Breinholt, {Marie Fredslund} and Helle Knudsen and Nielsen, {Signe Ledou} and Poulsen, {Tim Svenstrup} and Klausen, {Tobias Wirenfeldt} and Estrid H{\o}gdall and Peter N{\o}rgaard",
note = "This article is protected by copyright. All rights reserved.",
year = "2019",
month = "2",
day = "9",
doi = "10.1111/ejh.13219",
language = "English",
journal = "European Journal of Haematology",
issn = "0902-4441",
publisher = "Wiley-Blackwell Munksgaard",

}

RIS

TY - JOUR

T1 - Stratification by MYC expression has prognostic impact in MYC/BCL2 translocated B-cell lymphoma - identifies a subgroup of patients with poor outcome

AU - Pedersen, Mette Ølgod

AU - Gang, Anne Ortved

AU - Linde, Erik Clasen

AU - Breinholt, Marie Fredslund

AU - Knudsen, Helle

AU - Nielsen, Signe Ledou

AU - Poulsen, Tim Svenstrup

AU - Klausen, Tobias Wirenfeldt

AU - Høgdall, Estrid

AU - Nørgaard, Peter

N1 - This article is protected by copyright. All rights reserved.

PY - 2019/2/9

Y1 - 2019/2/9

N2 - OBJECTIVE: In patients with Large B-cell Lymphoma (LBCL) according to WHO the prognostic significance of MYC translocation is still not sufficiently clarified. We therefore aimed to investigate whether prognostication could be improved in patients with MYC translocation positive LBCL by additional stratification according to MYC and BCL2 protein expression levels or MYC translocation partner gene as well as concurrent BCL2 and/or BCL6 translocation (DH).METHODS: From an unselected consecutive cohort of >600 patients with LBCL investigated with fluorescent in situ hybridization (FISH) 64 patients were diagnosed with MYC translocation positive LBCL and included in the study. They were further investigated for supplemental translocations with FISH and MYC and BCL2 protein expression with immunohistochemistry (IHC).RESULTS: MYC expression >75% was associated with both reduced progression free survival (PFS) and overall survival (OS) (PFS: HR 6.8 (95%CI 1.5-31), p=0.004. OS: HR 4.3 (95%CI 0.9-21), p=0.05). Immunoglobulin (IG) MYC translocation partner gene was related to high MYC protein expression (p=0.047) but was not prognostic for PFS (p=0.8) or OS (p=0.6). DH did not confer a worse outcome compared to MYC single hit (SH). These findings were confirmed in a comparable, independent validation cohort of 28 patients with MYC translocation positive LBCL. All patients included in the survival analyses were treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) or R-CHOEP (R-CHOP+etoposide).CONCLUSION: These findings suggest that in patients with LBCL stratification by MYC protein expression level significantly improves the prognostic impact associated with MYC translocation. This article is protected by copyright. All rights reserved.

AB - OBJECTIVE: In patients with Large B-cell Lymphoma (LBCL) according to WHO the prognostic significance of MYC translocation is still not sufficiently clarified. We therefore aimed to investigate whether prognostication could be improved in patients with MYC translocation positive LBCL by additional stratification according to MYC and BCL2 protein expression levels or MYC translocation partner gene as well as concurrent BCL2 and/or BCL6 translocation (DH).METHODS: From an unselected consecutive cohort of >600 patients with LBCL investigated with fluorescent in situ hybridization (FISH) 64 patients were diagnosed with MYC translocation positive LBCL and included in the study. They were further investigated for supplemental translocations with FISH and MYC and BCL2 protein expression with immunohistochemistry (IHC).RESULTS: MYC expression >75% was associated with both reduced progression free survival (PFS) and overall survival (OS) (PFS: HR 6.8 (95%CI 1.5-31), p=0.004. OS: HR 4.3 (95%CI 0.9-21), p=0.05). Immunoglobulin (IG) MYC translocation partner gene was related to high MYC protein expression (p=0.047) but was not prognostic for PFS (p=0.8) or OS (p=0.6). DH did not confer a worse outcome compared to MYC single hit (SH). These findings were confirmed in a comparable, independent validation cohort of 28 patients with MYC translocation positive LBCL. All patients included in the survival analyses were treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) or R-CHOEP (R-CHOP+etoposide).CONCLUSION: These findings suggest that in patients with LBCL stratification by MYC protein expression level significantly improves the prognostic impact associated with MYC translocation. This article is protected by copyright. All rights reserved.

U2 - 10.1111/ejh.13219

DO - 10.1111/ejh.13219

M3 - Journal article

JO - European Journal of Haematology

JF - European Journal of Haematology

SN - 0902-4441

ER -

ID: 56690324