MYC or BCL2 copy number aberration is a strong predictor of outcome in patients with diffuse large B-cell lymphoma
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Ting-Xun Lu1, Lei Fan1, Li Wang1, Jia-Zhu Wu1, Kou-Rong Miao1, Jin-Hua Liang1, Qi-Xing Gong2, Zhen Wang2, Ken H. Young3, Wei Xu1, Zhi-Hong Zhang2, Jian-Yong Li1,4
1Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
2Department of Pathology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
3Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
4Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
Jian-Yong Li, e-mail: firstname.lastname@example.org
Keywords: MYC, BCL2, copy number aberration, diffuse large B-cell lymphoma, pathology
Received: February 27, 2015 Accepted: May 18, 2015 Published: May 29, 2015
Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma (NHL). Patients with DLBCL harboring MYC aberrations concurrent with BCL2 or/and BCL6 aberrations constitute a specific group with extremely poor outcome. In this study, we retrospectively investigated the incidence and prognosis of MYC, BCL2, and BCL6 aberrations with DLBCL patients in Chinese population. We applied fluorescence in situ hybridization and immunohistochemical analysis in 246 DLBCL patients. The results showed that patients with MYC or BCL2 copy number aberration (CNA) had significantly worse overall survival (OS) and progression-free survival (PFS) than negative cases (P < 0.0001). Patients with both MYC and BCL2 CNA had similar outcomes to those with classic double hit lymphoma or protein double expression lymphoma (MYC and BCL2/BCL6 coexpression). By multivariate analysis, MYC CNA, BCL2 CNA and double CNA were the independent worse prognostic factors. In conclusions, patients with MYC or BCL2 CNA constituted a unique group with extremely poor outcome and may require more aggressive treatment regimens.
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