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[Prognostic and Therapeutic Significance of Molecular Subtyping on Aged Patient with Advanced Diffuse Large B Cell
Li-Jun Xin1, Bo Yang1, Xue-Chun Lu1
1Department of Geriatric Hematology, General Hospital of Chinese PLA, Medical School of Chinese PLA, Beijing 100853, China.
Objective:
To analyze the clinical course of a very elderly patient with advanced diffuse large B cell lymphoma (DLBCL), so as to explore the incidence, prognosis and treatment of DLBCL and to analyse the prognostic and therapeutic significance of molecular subtype.
Methods:
The clinical history, auxiliary examinations, clinical diagnostic standards, therapeutic methods, biopsy and autopsy of this patient were retrospectively analyzed; the incidence, current treatment status, molecular biological features, and prognostic and therapeutic significance of molecular subtype were studied.
Results:
After admission, this patient was diagnosed as non-GCB DLBCL, NOS, stage IV B and in the high risk group (IPI = 5, ECOG = 2). She achieved a decent partial response after many times of imunochemotherapy, but his disease status soon progressed. The liver occupying biopsy revealed non-GCB, while the spleen tumor pathology revealed GCB; pathological typing of these two methods was completely opposite. Autopsy pathological diagnosis showed that the death causes included extensive tumor metastasis, dyscrasia and respiratory circle failure.
Conclusion:
Incidence of aged patients with DLBCL is high, and the disease is aggressive; the treatment is low responsive and difficult, and new therapeutic methods are needed. Gene expression profile (GEP) can provide molecular subtype and potential pathogenic mechanism, which can promote the development of new targeted therapy and individualized treatment.
