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COO and MYC/BCL2 status do not predict outcome among patients with stage I/II DLBCL: a retrospective multicenter study

Barraclough, Allison; Alzahrani, Musa; Ettrup, Marianne Schmidt; Bishton, Mark; van Vliet, Chris; Farinha, Pedro; Gould, Clare; Birch, Simone; Sehn, Laurie H.; Sovani, Vishakha; Ward, Mitchell Steven; Augustson, Bradley; Biccler, Jorne; Connors, Joseph M.; Scott, David W.; Gandhi, Maher K.; Savage, Kerry J.; El-Galaly, Tarec; Villa, Diego; Cheah, Chan Yoon

COO and MYC/BCL2 status do not predict outcome among patients with stage I/II DLBCL: a retrospective multicenter study Thumbnail


Authors

Allison Barraclough

Musa Alzahrani

Marianne Schmidt Ettrup

Mark Bishton

Chris van Vliet

Pedro Farinha

Clare Gould

Simone Birch

Laurie H. Sehn

Vishakha Sovani

Mitchell Steven Ward

Bradley Augustson

Jorne Biccler

Joseph M. Connors

David W. Scott

Maher K. Gandhi

Kerry J. Savage

Tarec El-Galaly

Diego Villa

Chan Yoon Cheah



Abstract

In advanced-stage diffuse large B-cell lymphoma (DLBCL), the presence of an activated B-cell phenotype or a non–germinal center (GCB) phenotype, coexpression of MYC and BCL2 by immunohistochemistry, and the cooccurrence of MYC and BCL2 or BCL6 rearrangements are associated with inferior outcomes. It is unclear whether these variables remain prognostic in stage I/II patients. In this retrospective study, we evaluated the prognostic impact of cell of origin (COO), as well as dual-expressor (DE) status and molecular double-hit (DH) status, in stage I/II DLBCL by positron emission tomography with computed tomography (PET-CT). A total of 211 patients treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)–like regimens, with or without radiotherapy, was included. The median follow-up in the entire cohort was 4 years (range, 0.4-9.4), with estimated 4-year progression-free survival (PFS) and overall survival (OS) rates of 85% (95% confidence interval [CI], 79-89) and 88% (95% CI, 83-92), respectively. By univariable analysis, DE (PFS: hazard ratio [HR], 1.27; 95% CI, 0.58-2.81, P 5 .55 and OS: HR, 1.40; 95% CI, 0.60-3.30; P 5 .44), DH (PFS: HR, 1.21; 95% CI, 0.27-5.31; P 5 .80 and OS: HR, 0.61; 95% CI, 0.08-4.73; P 5 .64), and non-GCB status (PFS: HR, 1.59; 95% CI, 0.83-3.03; P 5 .16 and OS: HR, 1.80; 95% CI, 0.89-3.67; P 5 .10) were associated with poorer outcomes. In patients with PET-CT–defined stage I/II DLBCL treated with R-CHOP–like therapy, with or without radiation, COO and DE and DH status were not significantly associated with inferior PFS or OS.

Citation

Barraclough, A., Alzahrani, M., Ettrup, M. S., Bishton, M., van Vliet, C., Farinha, P., …Cheah, C. Y. (2019). COO and MYC/BCL2 status do not predict outcome among patients with stage I/II DLBCL: a retrospective multicenter study. Blood Advances, 3(13), 2013-2021. https://doi.org/10.1182/bloodadvances.2019000251

Journal Article Type Article
Acceptance Date May 9, 2019
Online Publication Date Jul 8, 2019
Publication Date Jan 1, 2019
Deposit Date Dec 15, 2022
Publicly Available Date Jan 20, 2023
Journal Blood Advances
Electronic ISSN 2473-9537
Publisher American Society of Hematology
Peer Reviewed Peer Reviewed
Volume 3
Issue 13
Pages 2013-2021
DOI https://doi.org/10.1182/bloodadvances.2019000251
Keywords Hematology
Public URL https://nottingham-repository.worktribe.com/output/14322724
Publisher URL https://ashpublications.org/bloodadvances/article/3/13/2013/246628/COO-and-MYC-BCL2-status-do-not-predict-outcome