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Lymphoid cells and tissues are integral to the immune system, which is crucial in maintaining our body's defense against harmful pathogens. They form the building blocks of lymphoid organs, which include the spleen, thymus, and lymph nodes.
Lymphoid cells consist of various types of immune system cells. These include B and T lymphocytes, which are responsible for producing antibodies and killing infected cells, respectively. Dendritic cells act as messengers between the innate and adaptive...
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Genetics and diffuse large B-Cell lymphoma.

Rabin Niroula1, James Butera2

  • 1Roger Williams Medical Center, Department of Hematology and Oncology, Boston University School of Medicine, Providence, RI.

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|October 31, 2015
PubMed
Summary

Diffuse large B-cell lymphoma (DLBCL) has distinct subtypes, including double hit lymphoma (DHL). DA-EPOCH-R chemotherapy shows promise for treating DHL, which is resistant to standard RCHOP therapy.

Keywords:
Activated B-CellBCL-6 and BCL-2 oncogenesDA-EPOCH-RDiffuse large B cell lymphomaGerminal center B-CellMYCRCHOP

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Area of Science:

  • Hematology
  • Oncology
  • Molecular Biology

Background:

  • Diffuse large B-cell lymphoma (DLBCL) is an aggressive non-Hodgkin's lymphoma (NHL).
  • DLBCL exhibits distinct molecular subtypes: germinal center B-cell (GCB) and activated B-cell (ABC), driven by different oncogenic pathways.
  • Specific oncogenes (BCL-2, BCL-6, MYC) are implicated in DLBCL pathogenesis.

Purpose of the Study:

  • To investigate the molecular subtypes of DLBCL and their therapeutic implications.
  • To evaluate treatment strategies for double hit lymphoma (DHL), a subset of DLBCL with aggressive clinical course.
  • To assess the efficacy of DA-EPOCH-R chemotherapy in DHL.

Main Methods:

  • Gene expression profiling (GEP) to identify DLBCL molecular subtypes.
  • Analysis of oncogene co-expression, specifically identifying double hit lymphoma (DHL).
  • Review of treatment outcomes for DLBCL and DHL patients, including RCHOP and DA-EPOCH-R regimens.

Main Results:

  • DLBCL comprises GCB and ABC subtypes with distinct oncogenic signaling pathways.
  • Double hit lymphoma (DHL), characterized by co-expressed oncogenes, shows poor response to standard RCHOP therapy.
  • DA-EPOCH-R regimen demonstrates increased sensitivity and improved outcomes in DHL patients.

Conclusions:

  • DLBCL molecular subtypes have prognostic value and therapeutic relevance.
  • DHL represents a challenging subgroup of DLBCL requiring alternative treatment strategies.
  • DA-EPOCH-R chemotherapy is a promising new standard of care for double hit lymphoma.