Real world data on young patients with high-risk diffuse large B-cell lymphoma treated with R-CHOP or R-CHOEP - MYC, BCL2 and BCL6 as prognostic biomarkers

• DOI: 10.1371/journal.pone.0186983
• Publication Date: 2017-10-31T18:19:30Z
• Authors: Mette Ølgod Pedersen; Anne Ortved Gang; Peter Brown; Michael Pedersen; Helle Knudsen; Signe Ledou Nielsen; Tim Poulsen; Tobias Wirenfeldt...; Estrid Høgdall; Peter Nørgaard
• Keywords: BCL6; Immunophenotyping; Tissue microarray

Background Double expression of MYC and BCL2 proteins (DE) double-hit MYC+BCL2/BCL6 translocations (DH) were established as important biomarkers in patients with diffuse large B-cell lymphoma (DLBCL) by the 2016 revision World Health Organization classification lymphoid neoplasms. Whether this applies to subgroup young high risk DLBCL is not known. We previously found that a uniform retrospective population-based cohort aged 18–60 years high-risk DLBCL, addition etoposide R-CHOP chemotherapy (R-CHOEP) resulted improved survival mainly germinal center like (GCB) immunophenotype. The aim study was investigate prognostic predictive value DE DH patient cohort. Methods Data on all Danish diagnosed de novo 2004–2008 treated or R-CHOEP obtained from Lymphoma database (n = 159). Tumor samples available 103 patients. analyzed quantitative immunohistochemistry (IHC) using different cut off values. MYC-, BCL2- BCL6-translocations examined fluorescent situ hybridization (FISH). Results MYC>75% BCL2>85% an independent negative marker progression free (PFS) but (p<0.001), also after exclusion DH. A effect for response vs. almost significant (p 0.07). Conclusion In treatment may overcome impact observed R-CHOP.