Clinical Features and Immunophenotypes of Double-Hit Diffuse Large B-Cell Lymphoma

Area of Science:

• Hematology
• Oncology
• Genetics

Background:

• Double-hit (DH) genetics negatively impacts complete remission (CR) and overall survival (OS) in diffuse large B-cell lymphoma (DLBCL).
• Current methods for identifying DH genetics in DLBCL are time-consuming.

Purpose of the Study:

• To retrospectively analyze clinical features and outcomes of DLBCL patients stratified by DH genetics.
• To evaluate the predictive value of clinical and immunophenotypic markers for DH genetics.
• To identify factors associated with poor survival in DLBCL.

Main Methods:

• Retrospective review of 92 newly diagnosed DLBCL patients.
• Stratification into DH (n=14) and non-DH (n=78) groups.
• Comparison of clinical features, including bulky disease and double expresser (DE) status, and outcomes (OS).
• Multivariate analysis to identify mortality predictors.

Main Results:

• The DH group showed a higher incidence of bulky disease (64.3% vs. 28.2%, p=0.013) and DE positivity (50.0% vs. 21.8%, p=0.044).
• Three-year OS rates were significantly lower in the DH group (33.3%) compared to the non-DH group (52.2%, p=0.016).
• Advanced stage and comorbidities correlated with higher mortality.
• Combining DE status and bulky disease achieved 89.7% specificity for DH prediction.

Conclusions:

• DH genetics, not DE immunopositivity alone, is associated with inferior OS in DLBCL.
• Bulky disease and DE immunophenotype together can aid in predicting DH genetics in newly diagnosed DLBCL.
• These findings may help in earlier risk stratification and management of DLBCL patients.