Diagnosis and treatment in patients with B-cell lymphoma unclassified that is intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphoma
Aim. To characterize a group of patients with B-cell lymphoma (BCLU) unclassified that is intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphoma, to identify poor prognostic factors, and to evaluate therapeutic efficiency in patients with BCLU. Subjects and methods. Twenty-five pa...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | Russian |
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"Consilium Medicum" Publishing house
2015-08-01
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| Series: | Терапевтический архив |
| Subjects: | |
| Online Access: | https://ter-arkhiv.ru/0040-3660/article/view/31817 |
| _version_ | 1828863126537240576 |
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| author | E A Baryakh A E Misyurina A M Kovrigina T N Obukhova E G Gemdzhyan V I Vorobyev Ya K Mangasarova Yu Yu Polyakov A U Magomedova G A Klyasova V A Misyurin G A Yatsyk A A Shevelev I E Kostina A I Vorobyev S K Kravchenko |
| author_facet | E A Baryakh A E Misyurina A M Kovrigina T N Obukhova E G Gemdzhyan V I Vorobyev Ya K Mangasarova Yu Yu Polyakov A U Magomedova G A Klyasova V A Misyurin G A Yatsyk A A Shevelev I E Kostina A I Vorobyev S K Kravchenko |
| author_sort | E A Baryakh |
| collection | DOAJ |
| description | Aim. To characterize a group of patients with B-cell lymphoma (BCLU) unclassified that is intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphoma, to identify poor prognostic factors, and to evaluate therapeutic efficiency in patients with BCLU. Subjects and methods. Twenty-five patients with BCLU were examined. Double-hit lymphoma (DHL) was diagnosed in 8 (32%) patients. According to the Ann-Arbor classification of lymphoma, its stages II, III, and IV were diagnosed in 3 (12%), 2 (8%), and 20 (80%) patients, respectively. MYC rearrangement was observed in 11 (48%) out of 23 patients: single-hit lymphoma in 3 patients and DHL in 8 (BCL2+/MYC+ in 6 cases and BCL6+/MYC+ in 2). The expression of с-MYC (cut off ≥40%) was revealed in 17 (74%) out of 23 patients; that of BCL2 (cut off ≥50%) was detected in 14 (58%) out of 24 patients; coexpression of both proteins was seen in 12 (52%) out of 23 patients. The DHL group showed a correlation between the rearrangement of the BCL2+/MYC+ genes and the expression of MYC and BCL2 proteins in 5 out of 6 patients. Taking into account the heterogeneity of the entire patient group, DHL and non-DHL subgroups were considered separately. Both subgroups were comparable by clinical characteristics. BCLU patients younger than 60 years of age received treatment according to the LB-M-04 ± rituximab; those aged 60 or older had CHOP-like regimens ± rituximab. Autologous stem cell transplantation (auto-SCT) was performed in 5 patients belonging to a high-risk group. Results. The 3-year overall survival (OS) was 62% and the 3-year event-free survival (EFS) was 51%. The 3-year OS was lower for the DHL group than that for the non-DHL group (43 and 75%, respectively). Conclusion. In the DHL group, both OS and EFS are significantly lower (the risk of poor outcome, including death, is higher) than those in the non-DHL group. It is conceivable that intensified chemotherapy with auto-SCT increases treatment results in patients with BCLU; however, a larger number of observations are needed to obtain valid data. |
| first_indexed | 2024-12-13T03:37:32Z |
| format | Article |
| id | doaj.art-2362b11853f643aea20cd73cb2af1c4f |
| institution | Directory Open Access Journal |
| issn | 0040-3660 2309-5342 |
| language | Russian |
| last_indexed | 2024-12-13T03:37:32Z |
| publishDate | 2015-08-01 |
| publisher | "Consilium Medicum" Publishing house |
| record_format | Article |
| series | Терапевтический архив |
| spelling | doaj.art-2362b11853f643aea20cd73cb2af1c4f2022-12-22T00:01:00Zrus"Consilium Medicum" Publishing houseТерапевтический архив0040-36602309-53422015-08-01878778528834Diagnosis and treatment in patients with B-cell lymphoma unclassified that is intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphomaE A BaryakhA E MisyurinaA M KovriginaT N ObukhovaE G GemdzhyanV I VorobyevYa K MangasarovaYu Yu PolyakovA U MagomedovaG A KlyasovaV A MisyurinG A YatsykA A ShevelevI E KostinaA I VorobyevS K KravchenkoAim. To characterize a group of patients with B-cell lymphoma (BCLU) unclassified that is intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphoma, to identify poor prognostic factors, and to evaluate therapeutic efficiency in patients with BCLU. Subjects and methods. Twenty-five patients with BCLU were examined. Double-hit lymphoma (DHL) was diagnosed in 8 (32%) patients. According to the Ann-Arbor classification of lymphoma, its stages II, III, and IV were diagnosed in 3 (12%), 2 (8%), and 20 (80%) patients, respectively. MYC rearrangement was observed in 11 (48%) out of 23 patients: single-hit lymphoma in 3 patients and DHL in 8 (BCL2+/MYC+ in 6 cases and BCL6+/MYC+ in 2). The expression of с-MYC (cut off ≥40%) was revealed in 17 (74%) out of 23 patients; that of BCL2 (cut off ≥50%) was detected in 14 (58%) out of 24 patients; coexpression of both proteins was seen in 12 (52%) out of 23 patients. The DHL group showed a correlation between the rearrangement of the BCL2+/MYC+ genes and the expression of MYC and BCL2 proteins in 5 out of 6 patients. Taking into account the heterogeneity of the entire patient group, DHL and non-DHL subgroups were considered separately. Both subgroups were comparable by clinical characteristics. BCLU patients younger than 60 years of age received treatment according to the LB-M-04 ± rituximab; those aged 60 or older had CHOP-like regimens ± rituximab. Autologous stem cell transplantation (auto-SCT) was performed in 5 patients belonging to a high-risk group. Results. The 3-year overall survival (OS) was 62% and the 3-year event-free survival (EFS) was 51%. The 3-year OS was lower for the DHL group than that for the non-DHL group (43 and 75%, respectively). Conclusion. In the DHL group, both OS and EFS are significantly lower (the risk of poor outcome, including death, is higher) than those in the non-DHL group. It is conceivable that intensified chemotherapy with auto-SCT increases treatment results in patients with BCLU; however, a larger number of observations are needed to obtain valid data.https://ter-arkhiv.ru/0040-3660/article/view/31817b-cell lymphoma unclassifieddouble-hit lymphomaintensive therapyautologous stem cell transplantation |
| spellingShingle | E A Baryakh A E Misyurina A M Kovrigina T N Obukhova E G Gemdzhyan V I Vorobyev Ya K Mangasarova Yu Yu Polyakov A U Magomedova G A Klyasova V A Misyurin G A Yatsyk A A Shevelev I E Kostina A I Vorobyev S K Kravchenko Diagnosis and treatment in patients with B-cell lymphoma unclassified that is intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphoma Терапевтический архив b-cell lymphoma unclassified double-hit lymphoma intensive therapy autologous stem cell transplantation |
| title | Diagnosis and treatment in patients with B-cell lymphoma unclassified that is intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphoma |
| title_full | Diagnosis and treatment in patients with B-cell lymphoma unclassified that is intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphoma |
| title_fullStr | Diagnosis and treatment in patients with B-cell lymphoma unclassified that is intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphoma |
| title_full_unstemmed | Diagnosis and treatment in patients with B-cell lymphoma unclassified that is intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphoma |
| title_short | Diagnosis and treatment in patients with B-cell lymphoma unclassified that is intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphoma |
| title_sort | diagnosis and treatment in patients with b cell lymphoma unclassified that is intermediate between diffuse large b cell lymphoma and burkitt s lymphoma |
| topic | b-cell lymphoma unclassified double-hit lymphoma intensive therapy autologous stem cell transplantation |
| url | https://ter-arkhiv.ru/0040-3660/article/view/31817 |
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