MYC rearrangements in HIV-associated large B-cell lymphomas : EUROMYC, a European retrospective study
© 2024 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved..
ABSTRACT: Large B-cell lymphoma (LBCL) carrying MYC rearrangement, alone or together with BCL2 and/or BCL6 translocations, have shown a poor prognosis when treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in the HIV population. Scanty data are available on the prevalence and prognostic impact of MYC rearrangements in HIV-associated LBCL. We conducted a retrospective study to evaluate the clinical effect of MYC rearrangement in HIV-associated LBCL. We evaluated clinical characteristics, treatment received, and outcome of LBCL in patients with HIV with MYC rearrangement (MYC+) and without MYC rearrangement (MYC-). A total of 155 patients with HIV who had received fluorescence in situ hybridization analysis for MYC were enrolled in 11 European centers: 43 with MYC+ and 112 MYC-. Among patients with MYC, 10 had double-/triple-hit lymphomas, and 33 had isolated MYC rearrangement (single-hit lymphoma). Patients with MYC+ had more frequently advanced stage, >2 extranodal site at presentation, and higher proliferative index. There were no significant differences in overall survival and progression-free survival (PFS) between the 2 groups. However, patients with MYC+ received more frequently intensive chemotherapy (iCT) (44%) than (R)CHOP alone (35%) or infusional treatment (DA-EPOCH-R and R-CDE) (19%). Among patients with MYC+, those who received iCT achieved a better outcome than patients who received nonintensive treatment (complete remission, 84% vs 52%; P = .028; 5-year PFS, 66% vs 36%; P = .021). Our retrospective results suggest that HIV-associated LBCL with MYC+ could be considered for an intensive therapeutic approach whenever possible, whereas (R)CHOP seems to give inferior results in this subset of patients in terms of complete remission and PFS.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:8 |
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| Enthalten in: |
Blood advances - 8(2024), 4 vom: 27. Feb., Seite 968-977 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Pagani, Chiara [VerfasserIn] |
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| Links: |
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| Themen: |
4F4X42SYQ6 |
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| Anmerkungen: |
Date Completed 22.02.2024 Date Revised 22.02.2024 published: Print Citation Status MEDLINE |
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| doi: |
10.1182/bloodadvances.2023010704 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM36697792X |
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| 520 | |a © 2024 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved. | ||
| 520 | |a ABSTRACT: Large B-cell lymphoma (LBCL) carrying MYC rearrangement, alone or together with BCL2 and/or BCL6 translocations, have shown a poor prognosis when treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in the HIV population. Scanty data are available on the prevalence and prognostic impact of MYC rearrangements in HIV-associated LBCL. We conducted a retrospective study to evaluate the clinical effect of MYC rearrangement in HIV-associated LBCL. We evaluated clinical characteristics, treatment received, and outcome of LBCL in patients with HIV with MYC rearrangement (MYC+) and without MYC rearrangement (MYC-). A total of 155 patients with HIV who had received fluorescence in situ hybridization analysis for MYC were enrolled in 11 European centers: 43 with MYC+ and 112 MYC-. Among patients with MYC, 10 had double-/triple-hit lymphomas, and 33 had isolated MYC rearrangement (single-hit lymphoma). Patients with MYC+ had more frequently advanced stage, >2 extranodal site at presentation, and higher proliferative index. There were no significant differences in overall survival and progression-free survival (PFS) between the 2 groups. However, patients with MYC+ received more frequently intensive chemotherapy (iCT) (44%) than (R)CHOP alone (35%) or infusional treatment (DA-EPOCH-R and R-CDE) (19%). Among patients with MYC+, those who received iCT achieved a better outcome than patients who received nonintensive treatment (complete remission, 84% vs 52%; P = .028; 5-year PFS, 66% vs 36%; P = .021). Our retrospective results suggest that HIV-associated LBCL with MYC+ could be considered for an intensive therapeutic approach whenever possible, whereas (R)CHOP seems to give inferior results in this subset of patients in terms of complete remission and PFS | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 7 | |a Vincristine |2 NLM | |
| 650 | 7 | |a 5J49Q6B70F |2 NLM | |
| 650 | 7 | |a MYC protein, human |2 NLM | |
| 700 | 1 | |a Rusconi, Chiara |e verfasserin |4 aut | |
| 700 | 1 | |a Dalla Pria, Alessia |e verfasserin |4 aut | |
| 700 | 1 | |a Ravano, Emanuele |e verfasserin |4 aut | |
| 700 | 1 | |a Schommers, Philipp |e verfasserin |4 aut | |
| 700 | 1 | |a Bastos-Oreiro, Mariana |e verfasserin |4 aut | |
| 700 | 1 | |a Verga, Luisa |e verfasserin |4 aut | |
| 700 | 1 | |a Gini, Guido |e verfasserin |4 aut | |
| 700 | 1 | |a Spina, Michele |e verfasserin |4 aut | |
| 700 | 1 | |a Arcaini, Luca |e verfasserin |4 aut | |
| 700 | 1 | |a Steffanoni, Sara |e verfasserin |4 aut | |
| 700 | 1 | |a Dalu, Davide |e verfasserin |4 aut | |
| 700 | 1 | |a Crucitti, Lara |e verfasserin |4 aut | |
| 700 | 1 | |a Lorenzi, Luisa |e verfasserin |4 aut | |
| 700 | 1 | |a Balzarini, Piera |e verfasserin |4 aut | |
| 700 | 1 | |a Cattaneo, Chiara |e verfasserin |4 aut | |
| 700 | 1 | |a Bongiovanni, Lucia |e verfasserin |4 aut | |
| 700 | 1 | |a Rosenwald, Andreas |e verfasserin |4 aut | |
| 700 | 1 | |a Facchetti, Fabio |e verfasserin |4 aut | |
| 700 | 1 | |a Bower, Mark |e verfasserin |4 aut | |
| 700 | 1 | |a Ferreri, Andrés J M |e verfasserin |4 aut | |
| 700 | 1 | |a Rossi, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Tucci, Alessandra |e verfasserin |4 aut | |
| 700 | 1 | |a Re, Alessandro |e verfasserin |4 aut | |
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