Clinical Impact of MYC, BCL2, BCL6, and MALT1 Alterations in Diffuse Large B-Cell Lymphoma (DLBCL) in the Rituximab (R) Era
S Valera, T Cardesa, F Climent, V Romagosa, E Gonzalez, L Arenillas, S Serrano, JL Mate, O Salamero, A Lopez-Guillermo, E Campo, L Colomo. H. Clinic, Barcelona, Spain; H. de Bellvitge, Barcelona, Spain; H. del Mar, Barcelona, Spain; H. Germans Tries, Badalona, Grup Estudi Limfomes Catalunya i Balears (GELCAB), Spain
Background: The addition of R to the classic schemes of DLBCL has significantly improved the course of the disease. The impact of the genetic alterations has to be revisited.
Design: We have investigated the prognostic impact of the genetic alterations involving MYC, BCL2, BCL6 and MALT1 genes in a series of 126 patients with de novo DLBCL diagnosed between 2002 and 2007. FISH break-apart probes (Dako) were used, and translocations and gains were assessed in order to study their significance. Mediastinal, plasmablastic and immunosuppresion-associated lymphomas were excluded. Moreover, clinical, morphological and immunophenotypic profiles determined by the Hans classifier were correlated. 111 (88%) patients were treated with schemes including R (95 R-CHOP; 8 R-COP; 8 R-CHOP-ESHAP). 7(6%) did not receive treatment, 5(4%) received monotherapy, and 3(2%) only CHOP.
Results: The table summarizes the frequencies of the genetic alterations.
|Translocations||13 (10%)||19 (15%)||32 (26%)||0|
|Gains||19 (15%)||28 (22%)||31 (26%)||33 (28%)|
|No alterations||94 (75%)||78 (63%)||60 (48%)||86 (72%)|