MYC and BCL2 overexpression is associated with a higher class of Memorial Sloan-Kettering Cancer Center prognostic model and poor clinical outcome in primary diffuse large B-cell lymphoma of the central nervous systemReport as inadecuate




MYC and BCL2 overexpression is associated with a higher class of Memorial Sloan-Kettering Cancer Center prognostic model and poor clinical outcome in primary diffuse large B-cell lymphoma of the central nervous system - Download this document for free, or read online. Document in PDF available to download.

BMC Cancer

, 16:363

Medical and radiation oncology

Abstract

BackgroundPrimary diffuse large B-cell lymphoma of the central nervous system PCNS-DLBCL is a distinct clinicopathological entity with a poor prognosis. Concurrent MYC and BCL2 overexpression predicts inferior prognosis in systemic DLBCLs. However, the prognostic significance of MYC and BCL2 in PCNS-DLBCL remains elusive.

MethodsImmunohistochemistry IHC of MYC, BCL2 and BCL6 was performed on tumor samples from 114 patients with PCNS-DLBCL. IHC score was assigned based on the proportion of immunostained cells.

ResultsMYC, BCL2, and BCL6 IHC scores were 18.16 ± 19.58, 58.86 ± 35.07, and 39.39 ± 37.66 % mean ± SD, respectively. Twenty-one cases 18.1 % were designated as MYC-positive with a cutoff score of 40. BCL2 positivity was found in 87 cases 75.0 % using a cutoff score of 30. MSKCC Memorial Sloan-Kettering Cancer Center prognostic model class 2 and 3 had higher rates of MYC and-or BCL2 positivity MYC, P = 0.012; BCL2, P = 0.008; dual-positive, P = 0.022. Poor KPS Karnofsky Performance Status score <70, multifocal disease, Nottingham-Barcelona score ≥2, and MSKCC class 2 and 3 were related to shorter progression-free survival PFS P = 0.001, 0.037, 0.001, and 0.008, respectively. Patients with older age >60 years showed poorer overall survival OS P = 0.020. MYC positivity was associated with poor PFS P = 0.027, while patients with BCL2 positivity exhibited a shorter OS P = 0.010. Concomitant MYC and BCL2 positivity was related to poor PFS P = 0.041, while the lack of both MYC and BCL2 expression was related to prolonged OS P = 0.014. MYC and BCL2 expression had no independent prognostic implication by multivariate analysis in overall patients with PCNS-DLBCL. However, among patients treated with combined high-dose methotrexate, vincristine and procarbazine and radiotherapy, dual MYC and BCL2 overexpression a cutoff score of 60 was an independent poor prognostic indicator P = 0.010.

ConclusionsEvaluation of MYC and BCL2 expression may be helpful for the determination of PCNS-DLBCL prognosis.

KeywordsPrimary central nervous system lymphoma Diffuse large B-cell lymphoma MYC BCL2 Prognosis Electronic supplementary materialThe online version of this article doi:10.1186-s12885-016-2397-8 contains supplementary material, which is available to authorized users.

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Author: Sehui Kim - Soo Jeong Nam - Dohee Kwon - Hannah Kim - Eunyoung Lee - Tae Min Kim - Dae Seog Heo - Sung Hye Park - Chul

Source: https://link.springer.com/







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