Structural aberrations affecting the MYC locus indicate a poor prognosis independent of clinical risk factors in diffuse large B-cell lymphomas treated within randomized trials of the German High-Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL)
Structural aberrations affecting the MYC locus indicate a poor prognosis independent of clinical risk factors in diffuse large B-cell lymphomas treated within randomized trials of the German High-Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL)
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DOI：
10.1038/leu.2008.230
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发表时间：
2008-12-01
期刊：
影响因子：
11.4
通讯作者：
Siebert, Reiner
中科院分区：
文献类型：
--
作者：
Klapper, W.;Stoecklein, H.;Siebert, Reiner
最近对异质性治疗患者的回顾性研究表明，MYC 基因位点的染色体畸变表明弥漫性大 B 细胞淋巴瘤 (DLBCL) 的预后不良。在这里，我们通过间期荧光原位杂交分析了在两项非霍奇金淋巴瘤 NHL-B1 和 NHL-B2 前瞻性随机试验中治疗的 177 名新发 DLBCL 患者中 MYC 畸变的预后影响。在 14 例 DLBCL (7.9%) 中检测到 MYC 畸变。在单变量分析中，与 MYC 阴性 DLBCL 相比，MYC 阳性病例显示总生存期 (OS) 显着缩短 (P = 0.047)，并且相关但不显着的无事件生存期 (EFS) 也较短 (P = 0.062)。在根据国际预后指数调整的 Cox 模型中，MYC 基因重排的存在是 OS（相对风险 3.4，P = 0.004）和 EFS（相对风险 2.5，P = 0.015）最强的统计独立预测因子，当模型中包含通过免疫组织化学检测到的细胞源特征时，这一点也成立。
Recent retrospective studies of heterogeneously treated patients have suggested that chromosomal aberrations of the MYC gene locus indicate an unfavorable prognosis in diffuse large B-cell lymphoma (DLBCL). Here, we investigated the prognostic impact of MYC aberrations analyzed by interphase fluorescence in situ hybridization in 177 patients with de novo DLBCL treated within the two prospective, randomized trials non-Hodgkin's lymphoma NHL-B1 and NHL-B2. MYC aberrations were detected in 14 DLBCL (7.9%). In a univariate analysis compared with MYC-negative DLBCL, MYC-positive cases showed a significantly shorter overall survival (OS) (P = 0.047) and relevantly, though not significantly, shorter event-free survival (EFS) (P = 0.062). In a Cox model adjusted for the international prognostic index, the presence of a MYC gene rearrangement was the strongest statistically independent predictor of OS (relative risk 3.4, P = 0.004) and EFS (relative risk 2.5, P = 0.015), and this also held true when the cell-of-origin signature detected by immunohistochemistry was included in the model.