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- Title
MYC and BCL2 overexpression is associated with a higher class of Memorial Sloan-Kettering Cancer Center prognostic model and poor clinical outcome in primary diffuse large B-cell lymphoma of the central nervous system.
- Authors
Sehui Kim; Soo Jeong Nam; Dohee Kwon; Hannah Kim; Eunyoung Lee; Tae Min Kim; Dae Seog Heo; Sung Hye Park; Chul Woo Kim; Yoon Kyung Jeon; Kim, Sehui; Nam, Soo Jeong; Kwon, Dohee; Kim, Hannah; Lee, Eunyoung; Kim, Tae Min; Heo, Dae Seog; Park, Sung Hye; Kim, Chul Woo; Jeon, Yoon Kyung
- Abstract
<bold>Background: </bold>Primary diffuse large B-cell lymphoma of the central nervous system (PCNS-DLBCL) is a distinct clinicopathological entity with a poor prognosis. Concurrent MYC and BCL2 overexpression predicts inferior prognosis in systemic DLBCLs. However, the prognostic significance of MYC and BCL2 in PCNS-DLBCL remains elusive.<bold>Methods: </bold>Immunohistochemistry (IHC) of MYC, BCL2 and BCL6 was performed on tumor samples from 114 patients with PCNS-DLBCL. IHC score was assigned based on the proportion of immunostained cells.<bold>Results: </bold>MYC, BCL2, and BCL6 IHC scores were 18.16 ± 19.58, 58.86 ± 35.07, and 39.39 ± 37.66 % (mean ± SD), respectively. Twenty-one cases (18.1 %) were designated as MYC-positive with a cutoff score of 40. BCL2 positivity was found in 87 cases (75.0 %) using a cutoff score of 30. MSKCC (Memorial Sloan-Kettering Cancer Center prognostic model) class 2 and 3 had higher rates of MYC and/or BCL2 positivity (MYC, P = 0.012; BCL2, P = 0.008; dual-positive, P = 0.022). Poor KPS (Karnofsky Performance Status score <70), multifocal disease, Nottingham-Barcelona score ≥2, and MSKCC class 2 and 3 were related to shorter progression-free survival (PFS) (P = 0.001, 0.037, 0.001, and 0.008, respectively). Patients with older age (>60 years) showed poorer overall survival (OS) (P = 0.020). MYC positivity was associated with poor PFS (P = 0.027), while patients with BCL2 positivity exhibited a shorter OS (P = 0.010). Concomitant MYC and BCL2 positivity was related to poor PFS (P = 0.041), while the lack of both MYC and BCL2 expression was related to prolonged OS (P = 0.014). MYC and BCL2 expression had no independent prognostic implication by multivariate analysis in overall patients with PCNS-DLBCL. However, among patients treated with combined high-dose methotrexate, vincristine and procarbazine and radiotherapy, dual MYC and BCL2 overexpression (a cutoff score of 60) was an independent poor prognostic indicator (P = 0.010).<bold>Conclusions: </bold>Evaluation of MYC and BCL2 expression may be helpful for the determination of PCNS-DLBCL prognosis.
- Subjects
MEMORIAL Sloan-Kettering Cancer Center; B cells; LYMPHOMAS; CENTRAL nervous system; GENETIC overexpression; PROTEIN metabolism; B cell lymphoma; BIOCHEMISTRY; CENTRAL nervous system tumors; GENES; MATHEMATICAL models; PHENOMENOLOGY; PROGNOSIS; PSYCHOLOGICAL tests; SURVIVAL analysis (Biometry); THEORY; PAIN measurement; KARNOFSKY Performance Status
- Publication
BMC Cancer, 2016, Vol 16, p1
- ISSN
1471-2407
- Publication type
journal article
- DOI
10.1186/s12885-016-2397-8