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Clinical Impact of BTK Inhibitor Exposure in LymphGen-Defined MCD Diffuse Large B-Cell Lymphoma
Shiyu Jiang1,2, Yizhen Liu1,2, Ran Wei2,3
1Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Hematological Oncology
|July 21, 2026
Summary
Bruton tyrosine kinase inhibitors (BTKi) significantly improved progression-free survival in patients with MYD88/CD79B-altered diffuse large B-cell lymphoma (DLBCL). BTKi therapy also markedly reduced the risk of central nervous system relapse in this high-risk DLBCL subtype.
Area of Science:
- Oncology
- Hematology
- Molecular Biology
Background:
- MYD88/CD79B alterations define a distinct molecular subtype of diffuse large B-cell lymphoma (DLBCL).
- This MCD subtype is characterized by chronic active B-cell receptor signaling.
- MCD DLBCL has a high risk of central nervous system (CNS) involvement.
Purpose of the Study:
- To evaluate the clinical impact of Bruton tyrosine kinase inhibitors (BTKi) in patients with MCD DLBCL.
- To assess the efficacy of BTKi in improving progression-free survival (PFS) and reducing CNS relapse.
Main Methods:
- Retrospective analysis of 155 patients with newly diagnosed MCD DLBCL.
- Comparison of outcomes between patients exposed to BTKi and those not exposed.
- Statistical analysis including adjustment for IPI and CNS-IPI risk scores.
Main Results:
- BTKi exposure was associated with significantly improved 3-year PFS (93.8% vs. 66.6%, p < 0.001).
- BTKi remained an independent predictor of improved PFS (HR 0.16, p < 0.001).
- No CNS relapses occurred in the BTKi-treated group, compared to 15 events in the untreated group (HR 0.06, p = 0.002).
Conclusions:
- BTK inhibition may improve outcomes in MCD DLBCL.
- BTKi therapy appears to mitigate CNS relapse risk in this patient population.
- Further prospective studies are warranted to confirm these findings.