Haematologica (Nov 2018)

Inferior survival in high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements is not associated with MYC/IG gene rearrangements

  • Ellen D. McPhail,
  • Matthew J. Maurer,
  • William R. Macon,
  • Andrew L. Feldman,
  • Paul J. Kurtin,
  • Rhett P. Ketterling,
  • Rakhee Vaidya,
  • James R. Cerhan,
  • Stephen M. Ansell,
  • Luis F. Porrata,
  • Grzegorz S. Nowakowski,
  • Thomas E. Witzig,
  • Thomas M. Habermann

DOI
https://doi.org/10.3324/haematol.2018.190157
Journal volume & issue
Vol. 103, no. 11

Abstract

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High-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 rearrangements (double-/triple-hit lymphoma) have an aggressive clinical course. We investigated the prognostic value of transformation from low-grade lymphoma, cytological features (high grade versus large cell), MYC rearrangement partners (immunoglobulin versus nonimmunoglobulin gene), and treatment. We evaluated 100 adults with double-/triple-hit lymphoma, reviewing cytological features; cell of origin; and rearrangements of MYC, BCL2, and BCL6 using MYC, BCL2, and BCL6 break-apart and IGH/MYC, IGL/MYC, IGK/MYC, and IGH/BCL2 dual-fusion interphase fluorescence in situ hybridization probes. Outcome analysis was restricted to patients with lymphoma, de novo or at transformation, who received anthracycline-based chemotherapy. Among them, 60% had high-grade cytological features; 91% had a germinal center B-cell phenotype, and 60% had a MYC/IG rearrangement. Germinal center B-cell phenotype was associated with BCL2 rearrangements (P