Heterogeneity or change in cell of origin in diffuse large B-cell lymphomas determined using hans algorithm

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease.
• Cell of origin (COO) classification, such as germinal center B-cell (GCB) and non-GCB, impacts prognosis and treatment.
• Understanding COO stability is crucial for effective DLBCL management.

Purpose of the Study:

• To investigate the heterogeneity and change in COO within DLBCL patients.
• To analyze COO stability across different disease phases and sample sites.
• To identify factors associated with COO changes in DLBCL.

Main Methods:

• Utilized the Hans algorithm for COO classification based on immunohistochemical staining (CD10, BCL6, MUM1).
• Analyzed multiple DLBCL specimens from 156 patients, including initial diagnosis, simultaneous biopsies, and relapse samples.
• Correlated COO changes with specific marker expression patterns.

Main Results:

• COO was initially classified as GCB in 32% and non-GCB in 68% of patients.
• COO remained stable in 81% of patients but changed in 19% (GCB to non-GCB or vice versa).
• COO heterogeneity was observed in 14% of simultaneous samples, 7% of primary refractory sites, and 20% of relapse samples. Specific marker patterns showed varying rates of COO change (0-37%).

Conclusions:

• A significant proportion of DLBCL cases (19%) exhibit heterogeneous or changing COO.
• COO instability is more prevalent in certain disease phases and sample locations.
• Re-evaluation of COO in additional biopsy samples is recommended for personalized treatment strategies in DLBCL.