Sole rearrangement but not amplification of MYC is associated with a poor prognosis in patients with diffuse large B cell lymphoma and B cell lymphoma unclassifiable

Daniel J. Landsburg, Marissa K. Falkiewicz, Adam M. Petrich, Benjamin A. Chu, Amir Behdad, Shaoying Li, L. Jeffrey Medeiros, Ryan D. Cassaday, Nishitha M. Reddy, Martin A. Bast, Julie M. Vose, Kimberly R. Kruczek, Scott E. Smith, Priyank Patel, Francisco Hernandez-Ilizaliturri, Reem Karmali, Saurabh Rajguru, David T. Yang, Joseph J. Maly, Kristie A. BlumWeiqiang Zhao, Charles Vanslambrouck, Chadi Nabhan

Research output: Contribution to journalArticle

Abstract

Rearrangement of MYC is associated with a poor prognosis in patients with diffuse large B cell lymphoma (DLBCL) and B cell lymphoma unclassifiable (BCLU), particularly in the setting of double hit lymphoma (DHL). However, little is known about outcomes of patients who demonstrate MYC rearrangement without evidence of BCL2 or BCL6 rearrangement (single hit) or amplification (>4 copies) of MYC. We identified 87 patients with single hit lymphoma (SHL), 22 patients with MYC-amplified lymphoma (MYC amp) as well as 127 DLBCL patients without MYC rearrangement or amplification (MYC normal) and 45 patients with DHL, all treated with either R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) or intensive induction therapy. For SHL and MYC amp patients, the 2-year progression-free survival rate (PFS) was 49% and 48% and 2-year overall survival rate (OS) was 59% and 71%, respectively. SHL patients receiving intensive induction experienced higher 2-year PFS (59% vs. 23%, P = 0·006) but similar 2-year OS as compared with SHL patients receiving R-CHOP. SHL DLBCL patients treated with R-CHOP, but not intensive induction, experienced significantly lower 2-year PFS and OS (P < 0·001 for both) when compared with MYC normal patients. SHL patients appear to have a poor prognosis, which may be improved with receipt of intensive induction.

Original languageEnglish (US)
Pages (from-to)631-640
Number of pages10
JournalBritish Journal of Haematology
Volume175
Issue number4
DOIs
StatePublished - Nov 1 2016

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Keywords

  • B cell lymphoma unclassifiable
  • MYC
  • chemotherapy
  • diffuse large B cell lymphoma
  • fluorescence in situ hybridization

ASJC Scopus subject areas

  • Hematology

Cite this

Landsburg, D. J., Falkiewicz, M. K., Petrich, A. M., Chu, B. A., Behdad, A., Li, S., Medeiros, L. J., Cassaday, R. D., Reddy, N. M., Bast, M. A., Vose, J. M., Kruczek, K. R., Smith, S. E., Patel, P., Hernandez-Ilizaliturri, F., Karmali, R., Rajguru, S., Yang, D. T., Maly, J. J., ... Nabhan, C. (2016). Sole rearrangement but not amplification of MYC is associated with a poor prognosis in patients with diffuse large B cell lymphoma and B cell lymphoma unclassifiable. British Journal of Haematology, 175(4), 631-640. https://doi.org/10.1111/bjh.14282