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Prognostic significance of MYC, BCL2, and BCL6 rearrangements in patients with diffuse large B-cell lymphoma treated with cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab
Cancer, 01/03/2012
Clinical Article
Akyurek N et al. – Analysis of MYC gene rearrangement along with BCL2 and BCL6 is critical in identifying high-risk patients with poor prognosis.
Methods- Tissue microarrays were constructed from 239 cases of DLBCL, and expressions of CD10, BCL6, MUM1/IRF4, and BCL2 were evaluated by immunohistochemistry
- MYC, BCL2, and BCL6 rearrangements were investigated by interphase fluorescence in situ hybridization on tissue microarrays
- Survival analysis was constructed from 145 R-CHOP–treated patients
- MYC, BCL2, and BCL6 rearrangements were detected in 14 (6%), 36 (15%), and 69 (29%) of 239 DLBCL patients
- Double or triple rearrangements were detected in 7 (3%) of 239 DLBCL cases. Of these, 4 had BCL2 and MYC, 2 had BCL6 and MYC, and 1 had BCL2, BCL6, and MYC rearrangements
- Prognosis of these cases was extremely poor
- median survival of 9 months
- MYC rearrangement was associated with significantly worse OS (P = .01), especially for the cases with GC phenotype (P = .009)
- BCL6 rearrangement also predicted significantly shorter OS (P = .04), especially for the non-GC phenotype (P = .03)
- BCL2 rearrangement had no prognostic impact on outcome
- International Prognostic Index (P = .004) and MYC rearrangement (P = .009) were independent poor prognostic factors