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High-grade B-cell Lymphoma With MYC Rearrangement and Without BCL2 and BCL6 Rearrangements Is Associated With High
Shaoying Li1, Vivian L Weiss, Xuan J Wang
1Departments of *Pathology‡Hematology/Oncology, Vanderbilt University School of Medicine, Nashville, TN†Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX.
The American Journal of Surgical Pathology
|October 9, 2015
Summary
High-grade B-cell lymphomas with single MYC rearrangement (SHL) show distinct features but a poor prognosis similar to double-hit lymphomas (DHL). P53 overexpression may contribute to SHL
Area of Science:
- Hematology
- Oncology
- Molecular Pathology
Background:
- MYC/BCL2 double-hit lymphoma (DHL) is aggressive with poor treatment response.
- High-grade B-cell lymphoma with single MYC rearrangement (SHL) is less understood.
- Distinct clinicopathologic features and prognosis of SHL compared to DHL are unclear.
Purpose of the Study:
- To compare clinicopathologic features and outcomes of SHL versus DHL.
- To identify distinct characteristics of SHL.
- To evaluate the prognostic impact of p53 overexpression in SHL.
Main Methods:
- Retrospective analysis of 61 SHL and 83 DHL cases.
- Confirmation of MYC, BCL2, and BCL6 rearrangements using fluorescence in situ hybridization (FISH).
- Assessment of p53 overexpression and other markers (CD10, BCL2, BCL6) via immunohistochemistry.
Main Results:
- SHL tumors showed higher p53 overexpression (P=0.047) and less CD10, BCL2, BCL6 expression (P<0.05).
- MYC was more frequently partnered with IGH in SHL (P=0.04).
- SHL patients had poor overall survival (2-y OS: 41%), similar to DHL (48%) and worse than non-MYC/BCL2 rearranged lymphomas (P<0.0001).
Conclusions:
- SHL exhibits distinct clinicopathologic features compared to DHL.
- SHL carries a poor prognosis comparable to DHL.
- Increased p53 expression may contribute to the adverse outcome in SHL.
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