Faculty Collaboration Database

Impact of oncogene rearrangement patterns on outcomes in patients with double-hit non-Hodgkin lymphoma. Cancer 2016 Feb 15;122(4):559-64

Date

11/14/2015

Pubmed ID

26565895

Pubmed Central ID

PMC5068487

DOI

10.1002/cncr.29781

Scopus ID

2-s2.0-84959220657 (requires institutional sign-in at Scopus site)   64 Citations

Abstract

BACKGROUND: Double-hit lymphomas (DHLs) are collectively defined as B-cell non-Hodgkin lymphomas harboring rearrangements of MYC as well as B-cell lymphoma 2 (BCL2) and/or B-cell lymphoma 6 (BCL6). To the authors' knowledge, the impact of specific oncogene rearrangements on outcomes of patients with DHL who are treated with immunochemotherapy has not been previously described.

METHODS: The authors identified patients whose diagnostic tissue specimens underwent metaphase karyotyping or fluorescence in situ hybridization for MYC as well as both BCL2 and BCL6 rearrangements. Cohorts were defined by the presence (+) or absence (-) of rearrangements: MYC+/BCL2+/BCL6- (BCL2-DHL), MYC+/BCL2-/BCL6+ (BCL6-DHL), and MYC+/BCL2+/BCL6+ (triple-hit lymphoma; THL).

RESULTS: A total of 117 patients were included in the current analysis (76 BCL2-DHL patients, 16 BCL6-DHL patients, and 25 THL patients). Compared with patients with BCL2-DHL, those with BCL6-DHL were more likely to be classified as having a non-germinal center cell of origin, presented with extranodal disease, and appeared to achieve higher rates of complete response despite receiving intensive induction therapy less frequently. However, patients with BCL6-DHL experienced a shorter median overall survival if achieving an initial complete response compared with patients with BCL2-DHL. Patients with THL experienced survival outcomes similar to those of patients with BCL2-DHL.

CONCLUSIONS: Recognition of the specific oncogene rearrangements may be of prognostic value and potentially guide future therapeutic strategies for patients with DHL.

Author List

Landsburg DJ, Petrich AM, Abramson JS, Sohani AR, Press O, Cassaday R, Chavez JC, Song K, Zelenetz AD, Gandhi M, Shah N, Fenske TS, Jaso J, Medeiros LJ, Yang DT, Nabhan C

Author

Timothy Fenske MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Antineoplastic Combined Chemotherapy Protocols
Bone Marrow Neoplasms
Burkitt Lymphoma
Central Nervous System Neoplasms
Cohort Studies
Cyclophosphamide
Cytarabine
DNA-Binding Proteins
Databases, Factual
Dexamethasone
Doxorubicin
Etoposide
Female
Gene Rearrangement
Genes, bcl-2
Genes, myc
Germinal Center
Humans
Ifosfamide
Lymphoma, B-Cell
Lymphoma, Large B-Cell, Diffuse
Lymphoma, Non-Hodgkin
Male
Methotrexate
Middle Aged
Prednisone
Prognosis
Proto-Oncogene Proteins c-bcl-6
Rituximab
Survival Rate
Vincristine