MYC translocation and/or BCL 2 protein expression are associated with poor prognosis in diffuse large B-cell lymphoma.
MYC translocation and/or BCL 2 protein expression are associated with poor prognosis in diffuse large B-cell lymphoma.
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DOI：
10.1111/cas.12942
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发表时间：
2016-06
期刊：
影响因子：
5.7
通讯作者：
Takizawa J
中科院分区：
文献类型：
--
作者：
Kawamoto K;Miyoshi H;Yoshida N;Nakamura N;Ohshima K;Sone H;Takizawa J
基因组改变和蛋白表达水平已被确定为弥漫性大B细胞淋巴瘤（DLBCL）患者生存的预后因素。特别是，已知在MYC和BCL 2和/或BCL 6中表现出易位的双重打击DLBCL（DHL）与不良预后相关。然而，MYC、B-细胞淋巴瘤（BCL）2和BCL 6的基因改变和蛋白表达水平的临床意义尚不清楚。在这项研究中，我们分析了61例诊断为DLBCL的成人患者，他们接受了利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松龙或类似方案的治疗。不同MYC基因状态之间MYC表达率的分布没有差异。在对数秩检验中，MYC易位是总生存期（OS; P = 0.011）的预后因素，而BCL 2和BCL 6易位不是预后指标（分别为P = 0.999和P = 0.925）。MYC和BCL 6的表达水平与OS无显著相关性，但BCL 2的表达是影响OS的预后因素（P = 0.027）。此外，MYC、BCL 2和BCL 6基因的拷贝数增加并不影响OS。MYC易位（风险比，4.769;范围，1.518-14.98; P = 0.007）和BCL 2蛋白表达（风险比，3.072;范围，1.002-9.413; P = 0.049）是多变量分析中生存的独立预后因素。总之，MYC易位和BCL 2的表达可能需要在初步诊断DLBCL患者的预后进行调查。
Genomic alterations and protein expression levels have been established as prognostic factors for survival in patients with diffuse large B‐cell lymphoma (DLBCL). In particular, double‐hit DLBCL (DHL), which exhibits translocations in MYC and BCL2 and/or BCL6, is known to be associated with a poor prognosis. However, the clinical significance of gene alterations and protein expression levels for MYC, B‐cell lymphoma (BCL)2, and BCL6 are unclear. In this study, we analyzed 61 adult patients diagnosed with DLBCL without DHL, who were treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone, or similar regimens. There were no differences in the distribution of MYC expression rates among the different MYC gene statuses. In log–rank tests, MYC translocation was a prognostic factor for overall survival (OS; P = 0.011), whereas BCL2 and BCL6 translocation were not prognostic indicators (P = 0.999 and P = 0.925, respectively). Although the expression levels of MYC and BCL6 were not significantly associated with OS, the expression of BCL2 was a prognostic factor for OS (P = 0.027). Furthermore, copy number gains in the MYC, BCL2, and BCL6 genes did not affect OS. MYC translocation (hazard ratio, 4.769; range, 1.518–14.98; P = 0.007) and BCL2 protein expression (hazard ratio, 3.072; range, 1.002–9.413; P = 0.049) were independent prognostic factors for survival in multivariate analyses. In conclusion, MYC translocation and BCL2 expression may need to be investigated at the initial diagnosis to predict prognosis in patients with DLBCL.