학술논문

Adverse outcome in follicular lymphoma is associated with MYC rearrangements but not MYC extra copies.
Document Type
Article
Source
British Journal of Haematology. Jul2021, Vol. 194 Issue 2, p382-392. 11p.
Subject
*FOLLICULAR lymphoma
*OVERALL survival
*PROGRESSION-free survival
*PROGNOSIS
*UNIVARIATE analysis
Language
ISSN
0007-1048
Abstract
Summary: Follicular lymphomas (FLs) with MYC rearrangements (MYC‐R) and extra copies of MYC (MYC‐EC) are rare and the prognosis impact is uncertain. We conducted a retrospective study including 321 FL patients, among whom 259 (81%) had no 8q24 alterations and 62 (19%) were assigned to 8qAlt. Forty‐five cases were classified as MYC‐EC and six as MYC‐R. MYC‐R patients were significantly older (P = 0·008), had higher follicular lymphoma international prognostic index (FLIPI) stage (P = 0·05) and β2‐microglobulin (β2m; P = 0·05). Among patients treated with immuno‐chemotherapy, four presented a MYC‐R and 25 a MYC‐EC. Univariate analysis showed the absence of significant difference between MYC‐EC and normal MYC (MYC‐NL) regarding progression‐free survival (PFS; HR1·3; 95% CI [0·4–1·6]) and specific overall survival (SOS; HR 1·6; 95% CI [0·4–5·7]). Those results were compared to data from the PRIMA trial. This confirmed that MYC‐EC had no impact on PFS (P = 0·86) or SOS (P = 0·9). Conversely, MYC‐R was associated with a trend to inferior outcome regarding PFS (HR : 6·1; 95% CI [2·2–17·1]; P = 0·00026), lymphoma‐related death (SOS; HR 13·6; 95% CI [2·9–65]; P = 0·00014) and risk of transformation (transformation‐free survival (TFS); HR 82·7; 95% CI [14·8–463·4]; P < 0·0001). In conclusion, MYC‐EC has no prognostic impact in FL but MYC‐R FL tended to be associated with an increased risk of transformation and poorer outcome. [ABSTRACT FROM AUTHOR]