Impact of oncogene rearrangement patterns on outcomes in patients with double-hit non-Hodgkin lymphoma

Daniel J. Landsburg, Adam M. Petrich, Jeremy S. Abramson, Aliyah R. Sohani, Oliver Press, Ryan Cassaday, Julio C. Chavez, Kevin Song, Andrew D. Zelenetz, Mitul Gandhi, Namrata Shah, Timothy S. Fenske, Jesse Jaso, L. Jeffrey Medeiros, David T. Yang, Chadi Nabhan

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

BACKGROUND Double-hit lymphomas (DHLs) are collectively defined as B-cell non-Hodgkin lymphomas harboring rearrangements of MYC as well as B-cell lymphoma 2 (BCL2) and/or B-cell lymphoma 6 (BCL6). To the authors' knowledge, the impact of specific oncogene rearrangements on outcomes of patients with DHL who are treated with immunochemotherapy has not been previously described. METHODS The authors identified patients whose diagnostic tissue specimens underwent metaphase karyotyping or fluorescence in situ hybridization for MYC as well as both BCL2 and BCL6 rearrangements. Cohorts were defined by the presence (+) or absence (-) of rearrangements: MYC+/BCL2+/BCL6- (BCL2-DHL), MYC+/BCL2-/BCL6+ (BCL6-DHL), and MYC+/BCL2+/BCL6+ (triple-hit lymphoma; THL). RESULTS A total of 117 patients were included in the current analysis (76 BCL2-DHL patients, 16 BCL6-DHL patients, and 25 THL patients). Compared with patients with BCL2-DHL, those with BCL6-DHL were more likely to be classified as having a non-germinal center cell of origin, presented with extranodal disease, and appeared to achieve higher rates of complete response despite receiving intensive induction therapy less frequently. However, patients with BCL6-DHL experienced a shorter median overall survival if achieving an initial complete response compared with patients with BCL2-DHL. Patients with THL experienced survival outcomes similar to those of patients with BCL2-DHL. CONCLUSIONS Recognition of the specific oncogene rearrangements may be of prognostic value and potentially guide future therapeutic strategies for patients with DHL.

Original languageEnglish (US)
Pages (from-to)559-564
Number of pages6
JournalCancer
Volume122
Issue number4
DOIs
StatePublished - Feb 15 2016

Keywords

  • BCL2 (B-cell lymphoma 2)
  • BCL6 (B-cell lymphoma 6)
  • MYC
  • gene rearrangement
  • non-Hodgkin lymphoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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