Diffuse Large B-Cell Lymphoma in Kenya: MYC, BCL2, and the Cell of Origin
PURPOSE: Diffuse large B-cell lymphoma (DLBCL) is the most commonly diagnosed non-Hodgkin lymphoma in adults in Kenya. Cell of origin (COO) and double expression of MYC and BCL2 are two important prognostic factors for DLBCL. A small subset (5% to 10%) of DLBCL cases show positivity for CD5 and are...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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American Society of Clinical Oncology
2019-04-01
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| Series: | Journal of Global Oncology |
| Online Access: | http://ascopubs.org/doi/10.1200/JGO.18.00203 |
| _version_ | 1818133706467966976 |
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| author | Jonathan Wawire Shahin Sayed Zahir Moloo Aliyah R. Sohani |
| author_facet | Jonathan Wawire Shahin Sayed Zahir Moloo Aliyah R. Sohani |
| author_sort | Jonathan Wawire |
| collection | DOAJ |
| description | PURPOSE: Diffuse large B-cell lymphoma (DLBCL) is the most commonly diagnosed non-Hodgkin lymphoma in adults in Kenya. Cell of origin (COO) and double expression of MYC and BCL2 are two important prognostic factors for DLBCL. A small subset (5% to 10%) of DLBCL cases show positivity for CD5 and are associated with poor prognosis, whereas CD30 antigen, seen in up to 10% of cases, may be a useful target for therapy. We sought to determine the prevalence of MYC/BCL2 double expression, COO, and proportion of Epstein-Barr virus positivity among patients with DLBCL diagnosed at a tertiary referral laboratory in Kenya. PATIENTS AND METHODS: All cases of DLBCL diagnosed from 2012 through 2015 in our pathology department were analyzed. Tumor tissue microarray sections were stained with CD20, CD3, CD5, CD30, BCL2, BCL6, CD10, MUM1, MYC, and Ki67, classified for COO on the basis of the Hans algorithm, and subjected to Epstein-Barr virus-encoded small RNAs in situ hybridization. RESULTS: Among 165 DLBCL cases, the median age was 50 years, and there was no sex predilection. Only 18 (10.9%) cases showed double expression for MYC and BCL2. Germinal center B (GCB)-cell type DLBCL accounted for 67 cases (40.6%) and 97 cases (59.4%) were classified as non-GCB. The mean Ki67 proliferation index was significantly higher in the double-expressing (45%) and non-GCB groups (36%) compared with the non–double-expressing group (29%) and GCB group (26%). Sixteen cases (9.7%) were Epstein-Barr virus-encoded small RNAs positive, 12 (75%) of which were non-GCB. CONCLUSION: DLBCL in Kenya is seen in much younger patients with the poor prognostic non–GCB-type accounting for 59.4% of cases. MYC and BCL2 double expression was seen in fewer tumors than reported in the literature and in significantly older patients. |
| first_indexed | 2024-12-11T08:56:59Z |
| format | Article |
| id | doaj.art-14e7aff96dbf43fe8906182815dfe87b |
| institution | Directory Open Access Journal |
| issn | 2378-9506 |
| language | English |
| last_indexed | 2024-12-11T08:56:59Z |
| publishDate | 2019-04-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | Journal of Global Oncology |
| spelling | doaj.art-14e7aff96dbf43fe8906182815dfe87b2022-12-22T01:13:51ZengAmerican Society of Clinical OncologyJournal of Global Oncology2378-95062019-04-0151810.1200/JGO.18.002031Diffuse Large B-Cell Lymphoma in Kenya: MYC, BCL2, and the Cell of OriginJonathan Wawire0Shahin Sayed1Zahir Moloo2Aliyah R. Sohani3Aga Khan University, Nairobi, KenyaAga Khan University, Nairobi, KenyaAga Khan University, Nairobi, KenyaMassachusetts General Hospital, Boston, MAPURPOSE: Diffuse large B-cell lymphoma (DLBCL) is the most commonly diagnosed non-Hodgkin lymphoma in adults in Kenya. Cell of origin (COO) and double expression of MYC and BCL2 are two important prognostic factors for DLBCL. A small subset (5% to 10%) of DLBCL cases show positivity for CD5 and are associated with poor prognosis, whereas CD30 antigen, seen in up to 10% of cases, may be a useful target for therapy. We sought to determine the prevalence of MYC/BCL2 double expression, COO, and proportion of Epstein-Barr virus positivity among patients with DLBCL diagnosed at a tertiary referral laboratory in Kenya. PATIENTS AND METHODS: All cases of DLBCL diagnosed from 2012 through 2015 in our pathology department were analyzed. Tumor tissue microarray sections were stained with CD20, CD3, CD5, CD30, BCL2, BCL6, CD10, MUM1, MYC, and Ki67, classified for COO on the basis of the Hans algorithm, and subjected to Epstein-Barr virus-encoded small RNAs in situ hybridization. RESULTS: Among 165 DLBCL cases, the median age was 50 years, and there was no sex predilection. Only 18 (10.9%) cases showed double expression for MYC and BCL2. Germinal center B (GCB)-cell type DLBCL accounted for 67 cases (40.6%) and 97 cases (59.4%) were classified as non-GCB. The mean Ki67 proliferation index was significantly higher in the double-expressing (45%) and non-GCB groups (36%) compared with the non–double-expressing group (29%) and GCB group (26%). Sixteen cases (9.7%) were Epstein-Barr virus-encoded small RNAs positive, 12 (75%) of which were non-GCB. CONCLUSION: DLBCL in Kenya is seen in much younger patients with the poor prognostic non–GCB-type accounting for 59.4% of cases. MYC and BCL2 double expression was seen in fewer tumors than reported in the literature and in significantly older patients.http://ascopubs.org/doi/10.1200/JGO.18.00203 |
| spellingShingle | Jonathan Wawire Shahin Sayed Zahir Moloo Aliyah R. Sohani Diffuse Large B-Cell Lymphoma in Kenya: MYC, BCL2, and the Cell of Origin Journal of Global Oncology |
| title | Diffuse Large B-Cell Lymphoma in Kenya: MYC, BCL2, and the Cell of Origin |
| title_full | Diffuse Large B-Cell Lymphoma in Kenya: MYC, BCL2, and the Cell of Origin |
| title_fullStr | Diffuse Large B-Cell Lymphoma in Kenya: MYC, BCL2, and the Cell of Origin |
| title_full_unstemmed | Diffuse Large B-Cell Lymphoma in Kenya: MYC, BCL2, and the Cell of Origin |
| title_short | Diffuse Large B-Cell Lymphoma in Kenya: MYC, BCL2, and the Cell of Origin |
| title_sort | diffuse large b cell lymphoma in kenya myc bcl2 and the cell of origin |
| url | http://ascopubs.org/doi/10.1200/JGO.18.00203 |
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