A MYC-rearrangement is a negative prognostic factor in stage II, but not in stage I diffuse large B-cell lymphoma
Abstract MYC oncogene rearrangements (MYC-R) negatively affect survival in patients with Ann Arbor stage III–IV diffuse large B-cell lymphoma (DLBCL), but their impact in limited stage (LS) I–II is unclear. Therefore, we assessed the impact of MYC-R on progression-free survival (PFS) and overall sur...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Publishing Group
2024-01-01
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| Series: | Blood Cancer Journal |
| Online Access: | https://doi.org/10.1038/s41408-023-00971-y |
| _version_ | 1797363659742117888 |
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| author | A. V. de Jonge J. A. A. Bult D. F. E. Karssing M. Nijland M. E. D. Chamuleau M. Brink |
| author_facet | A. V. de Jonge J. A. A. Bult D. F. E. Karssing M. Nijland M. E. D. Chamuleau M. Brink |
| author_sort | A. V. de Jonge |
| collection | DOAJ |
| description | Abstract MYC oncogene rearrangements (MYC-R) negatively affect survival in patients with Ann Arbor stage III–IV diffuse large B-cell lymphoma (DLBCL), but their impact in limited stage (LS) I–II is unclear. Therefore, we assessed the impact of MYC-R on progression-free survival (PFS) and overall survival (OS) in LS DLBCL patients at the population level. We identified 1,434 LS DLBCL patients with known MYC-R status diagnosed between 2014 and 2020, who received R-CHOP(-like) regimens using the Netherlands Cancer Registry, with survival follow-up until February 2022. Stage I patients with (n = 83, 11%) and without (n = 650, 89%) a MYC-R had similar 2-years PFS (89% and 93%, p = 0.63) and OS (both 95%, p = 0.22). Conversely, stage II DLBCL patients with a MYC-R (n = 90, 13%) had inferior survival outcomes compared to stage II patients without a MYC-R (n = 611, 87%) (PFS 70% vs. 89%, p = 0.001; OS 79% vs. 94%, p < 0.0001). Both single MYC-R (single hit, n = 36) and concurrent BCL2 and/or BCL6 rearrangements (double/triple hit, n = 39) were associated with increased mortality and relapse risk. In conclusion, in stage II DLBCL a MYC-R is negatively associated with survival. In stage I DLBCL, however, survival outcomes are excellent irrespective of MYC-R status. This challenges the diagnostic assessment of MYC-R in stage I DLBCL patients. |
| first_indexed | 2024-03-08T16:23:18Z |
| format | Article |
| id | doaj.art-57195f4b508a4466b49258878d88cea4 |
| institution | Directory Open Access Journal |
| issn | 2044-5385 |
| language | English |
| last_indexed | 2024-03-08T16:23:18Z |
| publishDate | 2024-01-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Blood Cancer Journal |
| spelling | doaj.art-57195f4b508a4466b49258878d88cea42024-01-07T12:11:54ZengNature Publishing GroupBlood Cancer Journal2044-53852024-01-011411910.1038/s41408-023-00971-yA MYC-rearrangement is a negative prognostic factor in stage II, but not in stage I diffuse large B-cell lymphomaA. V. de Jonge0J. A. A. Bult1D. F. E. Karssing2M. Nijland3M. E. D. Chamuleau4M. Brink5Department of Hematology, Amsterdam UMC Location Vrije UniversiteitDepartment of Hematology, University Medical Center GroningenDepartment of Hematology, Amsterdam UMC Location Vrije UniversiteitDepartment of Hematology, University Medical Center GroningenDepartment of Hematology, Amsterdam UMC Location Vrije UniversiteitDepartment of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL)Abstract MYC oncogene rearrangements (MYC-R) negatively affect survival in patients with Ann Arbor stage III–IV diffuse large B-cell lymphoma (DLBCL), but their impact in limited stage (LS) I–II is unclear. Therefore, we assessed the impact of MYC-R on progression-free survival (PFS) and overall survival (OS) in LS DLBCL patients at the population level. We identified 1,434 LS DLBCL patients with known MYC-R status diagnosed between 2014 and 2020, who received R-CHOP(-like) regimens using the Netherlands Cancer Registry, with survival follow-up until February 2022. Stage I patients with (n = 83, 11%) and without (n = 650, 89%) a MYC-R had similar 2-years PFS (89% and 93%, p = 0.63) and OS (both 95%, p = 0.22). Conversely, stage II DLBCL patients with a MYC-R (n = 90, 13%) had inferior survival outcomes compared to stage II patients without a MYC-R (n = 611, 87%) (PFS 70% vs. 89%, p = 0.001; OS 79% vs. 94%, p < 0.0001). Both single MYC-R (single hit, n = 36) and concurrent BCL2 and/or BCL6 rearrangements (double/triple hit, n = 39) were associated with increased mortality and relapse risk. In conclusion, in stage II DLBCL a MYC-R is negatively associated with survival. In stage I DLBCL, however, survival outcomes are excellent irrespective of MYC-R status. This challenges the diagnostic assessment of MYC-R in stage I DLBCL patients.https://doi.org/10.1038/s41408-023-00971-y |
| spellingShingle | A. V. de Jonge J. A. A. Bult D. F. E. Karssing M. Nijland M. E. D. Chamuleau M. Brink A MYC-rearrangement is a negative prognostic factor in stage II, but not in stage I diffuse large B-cell lymphoma Blood Cancer Journal |
| title | A MYC-rearrangement is a negative prognostic factor in stage II, but not in stage I diffuse large B-cell lymphoma |
| title_full | A MYC-rearrangement is a negative prognostic factor in stage II, but not in stage I diffuse large B-cell lymphoma |
| title_fullStr | A MYC-rearrangement is a negative prognostic factor in stage II, but not in stage I diffuse large B-cell lymphoma |
| title_full_unstemmed | A MYC-rearrangement is a negative prognostic factor in stage II, but not in stage I diffuse large B-cell lymphoma |
| title_short | A MYC-rearrangement is a negative prognostic factor in stage II, but not in stage I diffuse large B-cell lymphoma |
| title_sort | myc rearrangement is a negative prognostic factor in stage ii but not in stage i diffuse large b cell lymphoma |
| url | https://doi.org/10.1038/s41408-023-00971-y |
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