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Prognostic Value of cMYC Gene Abnormalities in Diffuse Large B Cell Lymphoma Treated with Chemo-Immunotherapy

Publication ,  Conference
López, AB; de Villambrosia, SG; Montes-Moreno, S; Mazorra, F; Insunza, A; Sáez, A; Montalban, C; Sánchez, L; Garcia, JF; González-Barca, E ...
Published in: Blood
November 18, 2011

Abstract 2664Diffuse large B cell lymphoma (DLBCL) is a heterogeneous group of aggressive lymphomas. Despite improvements in diagnostic and therapeutic procedures, DLBCL still represents a significant cause of morbidity and mortality. Two molecularly defined types of DLBCL have been recently described: the germinal center B-cell (GCB) and the activated B-cell (ABC) subtype. GCB type DLBCL has been shown to have a better OS and PFS than ABC-type in multiple series of DLBCL patients treated with chemoimmunotherapy. The processes involved in lymphomagenesis in both subtypes are not fully understood, but deregulated expression of various proto-oncogenes is observed, often as the result of chromosomal translocations leading to constitutive gene expression. The specific role of the cMYC gene abnormalities in the pathogenesis of these lymphomas is still a matter of debate. To address this question, the status of the cMYC gene was analyzed by interphase fluorescence in situ hybridization (FISH) using a break apart probe, in TMA arranged tissue samples from 241 patients with de novo DLBCL treated with chemoimmunotherapy (R-CHOP and R-CHOP-like regimens). cMYC was rearranged in 15 cases out of 166 evaluable (9.26%). We did not find differences in the incidence of cMYC rearrangements between GCB and ABC-DLBCL subtypes (9/74 GCB and 6/82 ABC type) as classified according to extended immunohistochemical algorithms (Choi et al in Cancer Res. 2009). In our series, patients with DLBCL and cMYC rearrangements presented more frequently extranodal disease (p=0.007), higher IPI (p=0.037) and tended to have less than 60 years (p=0.053). cMYC gains were observed in 33 cases (21.85%). In the univariate analysis, cMYC abnormalities (gains and rearrangements) had no impact on the clinical outcome in the ABC subtype. However, whilst the cMYC gains did not identify a risk group in terms of OS or PFS the presence of cMYC rearrangements showed a significantly inferior progression-free survival (PFS) in the GCB-type group (p<0.006). However, the multivariate analysis showed that the only independent adverse predictors in these series of DLBCL cases were the presence of a high International Prognostic Index score (p=0.0028; RR=2.59 95% CI 1,34–4,99) and the ABC phenotype (p=0.0182; RR=2.16 95% CI 1,1–4,21). In summary, although cMYC rearrangements apparently do not provide additional prognostic information to the IPI score and/or GC-ABC classification in the whole DLBCL population, it identifies a subgroup of GCB-type DLBCL with very poor outcome.

Duke Scholars

Published In

Blood

DOI

EISSN

1528-0020

ISSN

0006-4971

Publication Date

November 18, 2011

Volume

118

Issue

21

Start / End Page

2664 / 2664

Publisher

American Society of Hematology

Related Subject Headings

  • Immunology
  • 3213 Paediatrics
  • 3201 Cardiovascular medicine and haematology
  • 3101 Biochemistry and cell biology
  • 1114 Paediatrics and Reproductive Medicine
  • 1103 Clinical Sciences
  • 1102 Cardiorespiratory Medicine and Haematology
 

Citation

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López, A. B., de Villambrosia, S. G., Montes-Moreno, S., Mazorra, F., Insunza, A., Sáez, A., … Conde, E. (2011). Prognostic Value of cMYC Gene Abnormalities in Diffuse Large B Cell Lymphoma Treated with Chemo-Immunotherapy. In Blood (Vol. 118, pp. 2664–2664). American Society of Hematology. https://doi.org/10.1182/blood.v118.21.2664.2664
López, Ana Batlle, Sonia Glez de Villambrosia, Santiago Montes-Moreno, Francisco Mazorra, Andrés Insunza, Anabel Sáez, Carlos Montalban, et al. “Prognostic Value of cMYC Gene Abnormalities in Diffuse Large B Cell Lymphoma Treated with Chemo-Immunotherapy.” In Blood, 118:2664–2664. American Society of Hematology, 2011. https://doi.org/10.1182/blood.v118.21.2664.2664.
López AB, de Villambrosia SG, Montes-Moreno S, Mazorra F, Insunza A, Sáez A, et al. Prognostic Value of cMYC Gene Abnormalities in Diffuse Large B Cell Lymphoma Treated with Chemo-Immunotherapy. In: Blood. American Society of Hematology; 2011. p. 2664–2664.
López, Ana Batlle, et al. “Prognostic Value of cMYC Gene Abnormalities in Diffuse Large B Cell Lymphoma Treated with Chemo-Immunotherapy.” Blood, vol. 118, no. 21, American Society of Hematology, 2011, pp. 2664–2664. Crossref, doi:10.1182/blood.v118.21.2664.2664.
López AB, de Villambrosia SG, Montes-Moreno S, Mazorra F, Insunza A, Sáez A, Montalban C, Sánchez L, Garcia JF, González-Barca E, López A, Ruiz-Marcellan MC, Mollejo M, Grande C, Dunphy CH, His ED, Go RS, Visco C, Xu-Monette ZY, Young KH, Piris M, Conde E. Prognostic Value of cMYC Gene Abnormalities in Diffuse Large B Cell Lymphoma Treated with Chemo-Immunotherapy. Blood. American Society of Hematology; 2011. p. 2664–2664.

Published In

Blood

DOI

EISSN

1528-0020

ISSN

0006-4971

Publication Date

November 18, 2011

Volume

118

Issue

21

Start / End Page

2664 / 2664

Publisher

American Society of Hematology

Related Subject Headings

  • Immunology
  • 3213 Paediatrics
  • 3201 Cardiovascular medicine and haematology
  • 3101 Biochemistry and cell biology
  • 1114 Paediatrics and Reproductive Medicine
  • 1103 Clinical Sciences
  • 1102 Cardiorespiratory Medicine and Haematology