@article{5eaa4c965490421e98dd4291f388c0b0,
title = "Prognostic impact of concurrent MYC and BCL6 rearrangements and expression in de novo diffuse large B-cell lymphoma",
abstract = "Double-hit B-cell lymphoma is a common designation for a group of tumors characterized by concurrent translocations of MYC and BCL2, BCL6, or other genes. The prognosis of concurrent MYC and BCL6 translocations is not well known. In this study, we assessed rearrangements and expression of MYC, BCL2 and BCL6 in 898 patients with de novo diffuse large B-cell lymphoma treated with standard chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab). Neither BCL6 translocation alone (more frequent in activated B-cell like diffuse large B-cell lymphoma) nor in combination with MYC translocation (observed in 2.0% of diffuse large B-cell lymphoma) predicted poorer survival in diffuse large B-cell lymphoma patients. Diffuse large B-cell lymphoma patients with MYC/BCL6 co-expression did have significantly poorer survival, however, MYC/BCL6 co-expression had no effect on prognosis in the absence of MYC/BCL2 co-expression, and had no additive impact in MYC+/BCL2+ cases. The isolated MYC+/BCL6+/BCL2-subset, more frequent in germinal center B-cell like diffuse large B-cell lymphoma, had significantly better survival compared with the isolated MYC+/BCL2+/BCL6-subset (more frequent in activated B-cell like diffuse large B-cell lymphoma). In summary, diffuse large B-cell lymphoma patients with either MYC/BCL6 rearrangements or MYC/BCL6 co-expression did not always have poorer prognosis; MYC expression levels should be evaluated simultaneously; and double-hit B-cell lymphoma needs to be refined based on the specific genetic abnormalities present in these tumors.",
keywords = "BCL2, BCL6, Diffuse large B-cell lymphoma, Double-hit, MYC",
author = "Qing Ye and Xu-Monette, {Zijun Y.} and Alexandar Tzankov and Lijuan Deng and Xiaoxiao Wang and Manyam, {Ganiraju C.} and Carlo Visco and Santiago Montes-Moreno and Li Zhang and Karen Dybk{\ae}r and April Chiu and Attilio Orazi and Youli Zu and Govind Bhagat and Richards, {Kristy L.} and Hsi, {Eric D.} and Choi, {William W.L.} and {van Krieken}, {J. Han} and Jooryung Huh and Maurilio Ponzoni and Ferreri, {Andr{\'e}s J.M.} and Parsons, {Ben M.} and M{\o}ller, {Michael B.} and Piris, {Miguel A.} and Winter, {Jane N.} and Medeiros, {L. Jeffrey} and Hu, {van den Shimin} and Young, {Ken H.}",
note = "Funding Information: This study is supported by the National Cancer Institute and National Institutes of Health grants (R01CA138688 and R01CA187415, K.H.Y). QY is the recipient of pathology scholarship award from Jiangsu Province for Oversea Studies (JS-2011-093) and Nanjing Medical Science and Technology Development Foundation (ORX11080). ZYXM is the recipient of the Harold C. and Mary L. Daily Endowment Fellowships and Shannon Timmins Fellowship for Leukemia Research Award. KHY is supported by The University of Texas MD Anderson Cancer Center Lymphoma Moonshot Program, Institutional Research Grant Award, an MD Anderson Lymphoma Specialized Programs of Research Excellence (SPORE) Research Development Program Award, an MD Anderson Myeloma SPORE Research Development Program Award, MD Anderson Collaborative Research Funds with High-Throughput Molecular Diagnostics, Gilead Pharmaceutical, Adaptive Biotechnology, Seattle Genetics, and Roche Molecular Systems. This work was also partially supported by National Cancer Institute and National Institutes of Health grants (P50CA136411 and P50CA142509), and by the MD Anderson Cancer Center Support Grant CA016672.",
year = "2016",
doi = "10.18632/oncotarget.6262",
language = "English (US)",
volume = "7",
pages = "2401--2416",
journal = "Oncotarget",
issn = "1949-2553",
publisher = "Impact Journals",
number = "3",
}