MYC+ diffuse large B-cell lymphoma is not salvaged by classical R-ICE or R-DHAP followed by BEAM plus autologous stem cell transplantation

Publication

MYC+ diffuse large B-cell lymphoma is not salvaged by classical R-ICE or R-DHAP followed by BEAM plus autologous stem cell transplantation

Journal Paper/Review - Mar 9, 2012

Cuccuini Wendy, Gisselbrecht Christian, Houlgatte Remi, Gaulard Philippe, Soulier Jean, Bron Dominique, Ysebaert Loic, Hirchaud Edouard, Cogliatti Sergio B., Sundstrom Christer, Rosenwald Andreas, Voelker Hans-Ullrich, Mounier Nicolas, Briere Josette, Thieblemont Catherine

Citation

Cuccuini W, Gisselbrecht C, Houlgatte R, Gaulard P, Soulier J, Bron D, Ysebaert L, Hirchaud E, Cogliatti S, Sundstrom C, Rosenwald A, Voelker H, Mounier N, Briere J, Thieblemont C. MYC+ diffuse large B-cell lymphoma is not salvaged by classical R-ICE or R-DHAP followed by BEAM plus autologous stem cell transplantation. Blood 2012; 119:4619-24.

Type

Journal Paper/Review (English)

Journal

Blood 2012; 119

Publication Date

Mar 9, 2012

Issn Electronic

1528-0020

Pages

4619-24

Brief description/objective

Approximately 5-10% of diffuse large B-cell lymphomas (DLBCL) harbor a 8q24/MYC rearrangement (MYC(+)). We determined the prognostic significance of MYC rearrangement in patients with relapsed/refractory DLBCL prospectively treated by R-ICE or R-DHAP followed by high-dose therapy and autologous stem cell transplantation. Twenty-eight (17%) of the 161 patients analyzed presented a MYC(+) rearrangement, targeted as either simple hit (25%) or complex hits (n=75%) including MYC/BCL2, MYC/BCL6, and MYC/BCL2/BCL6. Results were statistically highly concordant in matched primary and relapsed biopsies (n = 45). Compared to the MYC(-) DLBCL patients, the MYC(+) DLBCL patients presented with a more elevated lactico-deshydrogenase level (P = .0006) and a more advanced age adjusted international prognostic index (P = .0039). The 4-year PFS and OS were significantly lower in the MYC(+) DLBCL patients than those in the MYC(-) DLBCL patients, with rates of 18% vs 42% (P = .0322), and of 29% vs 62% (P = .0113), respectively. Type of treatment, R-DHAP or R-ICE, had no impact on survivals, with 4-year PFS rates of 17% vs 19% and 4-year OS rates of 26% vs 31%. In conclusion, MYC rearrangement is an early event in DLBCL. MYC(+) DLBCL patients have a significant inferior prognosis than MYC(-) DLBCL patients. Their outcome was not influenced by the proposed salvage therapy.