MYC/BCL2 protein coexpression contributes to the inferior survival of activated B-cell subtype of diffuse large B-cell lymphoma and demonstrates high-risk gene …

S Hu, ZY Xu-Monette, A Tzankov… - Blood, The Journal …, 2013 - ashpublications.org
S Hu, ZY Xu-Monette, A Tzankov, T Green, L Wu, A Balasubramanyam, W Liu, C Visco, Y Li
Blood, The Journal of the American Society of Hematology, 2013ashpublications.org
Diffuse large B-cell lymphoma (DLBCL) is stratified into prognostically favorable germinal
center B-cell (GCB)–like and unfavorable activated B-cell (ABC)–like subtypes based on
gene expression signatures. In this study, we analyzed 893 de novo DLBCL patients treated
with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). We
show that MYC/BCL2 protein coexpression occurred significantly more commonly in the
ABC subtype. Patients with the ABC or GCB subtype of DLBCL had similar prognoses with …
Diffuse large B-cell lymphoma (DLBCL) is stratified into prognostically favorable germinal center B-cell (GCB)–like and unfavorable activated B-cell (ABC)–like subtypes based on gene expression signatures. In this study, we analyzed 893 de novo DLBCL patients treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). We show that MYC/BCL2 protein coexpression occurred significantly more commonly in the ABC subtype. Patients with the ABC or GCB subtype of DLBCL had similar prognoses with MYC/BCL2 coexpression and without MYC/BCL2 coexpression. Consistent with the notion that the prognostic difference between the 2 subtypes is attributable to MYC/BCL2 coexpression, there is no difference in gene expression signatures between the 2 subtypes in the absence of MYC/BCL2 coexpression. DLBCL with MYC/BCL2 coexpression demonstrated a signature of marked downregulation of genes encoding extracellular matrix proteins, those involving matrix deposition/remodeling and cell adhesion, and upregulation of proliferation-associated genes. We conclude that MYC/BCL2 coexpression in DLBCL is associated with an aggressive clinical course, is more common in the ABC subtype, and contributes to the overall inferior prognosis of patients with ABC-DLBCL. In conclusion, the data suggest that MYC/BCL2 coexpression, rather than cell-of-origin classification, is a better predictor of prognosis in patients with DLBCL treated with R-CHOP.
ashpublications.org