PMID- 35152630 OWN - NLM STAT- MEDLINE DCOM- 20220215 LR - 20220531 IS - 0529-5807 (Print) IS - 0529-5807 (Linking) VI - 51 IP - 2 DP - 2022 Feb 8 TI - [Clinicopathological features and prognosis of high-grade B-cell lymphoma with MYC and bcl-2 and/or bcl-6 rearrangements]. PG - 120-125 LID - 10.3760/cma.j.cn112151-20210826-00604 [doi] AB - Objective: To investigate the clinicopathological characteristics and prognosis of high-grade B-cell lymphoma (HGBL) involving combined rearrangements of MYC, bcl-2 and bcl-6. Methods: A total of 1 138 cases of large B cell lymphoma (LBL) that were treated at the Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2017 to September 2020 were analyzed using fluorescence in situ hybridization (FISH) with probes against MYC, bcl-2 and bcl-6. The clinical and pathological data of the 45 patients with HGBL that had rearrangements of MYC and bcl-2 and/or bcl-6 were collected and retrospectively analyzed. Results: Among the 1 138 LBL, 45 (4.0%) cases had combined rearrangements of MYC, bcl-2 and/or bcl-6 that included 6 HGBL cases with MYC, bcl-2 and bcl-6 rearrangements, 14 HGBL cases with MYC and bcl-2 rearrangements, and 25 HGBL cases with MYC and bcl-6 rearrangements. Of these 45 patients, 29 patients were male, and 16 patients were female, aged 29 to 83 years. HGBL with MYC, bcl-2 and bcl-6 rearrangements and HGBL with MYC and bcl-2 rearrangement were reclassified as the germinal center B-cell (GCB) subtype using the Hans algorithm. HGBL with MYC and bcl-6 rearrangement were reclassified as the GCB subtype (68.0%) and the non-GCB subtype (32.0%). The vast majority of HGBL cases had a high Ki-67 proliferation index. Most HGBL patients had advanced stage disease with a high IPI score and an increased LDH level. Also, some patients had clinical features including elevated plasma beta2-microglobulin levels, B symptoms, and bone marrow involvement. The IPI scores and LDH levels were significantly different between the HGBL cases with MYC, bcl-2 and bcl-6 rearrangements and the HGBL cases with MYC and bcl-6 rearrangements (P<0.05). Compared with the HGBL cases with MYC, bcl-2 and bcl-6 rearrangements, the HGBL cases with MYC and bcl-2 or bcl-6 rearrangements had a lower incidence of bone marrow involvement (P<0.05). There were no significant differences in the prognosis among HGBL cases with MYC, bcl-2 and bcl-6 rearrangements, the cases with MYC and bcl-2 rearrangements, and the cases with MYC and bcl-6 rearrangements (P>0.05). Conclusions: HGBL with MYC, bcl-2 and/or bcl-6 rearrangements are rare types of B-cell lymphoma with high degree of malignancy and have a short overall survival. To reduce misdiagnosis and improve diagnostic accuracy, it is necessary to assess the patients' clinical features and conduct histopathological, immunohistochemical and FISH analyses. FAU - Shen, X AU - Shen X AD - Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China. FAU - Zhou, L T AU - Zhou LT AD - Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China. FAU - Li, A Q AU - Li AQ AD - Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China. FAU - Yi, H M AU - Yi HM AD - Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China. FAU - Ouyang, B S AU - Ouyang BS AD - Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China. FAU - Xu, H M AU - Xu HM AD - Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China. FAU - Xie, J L AU - Xie JL AD - Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China. FAU - Gu, Y J AU - Gu YJ AD - Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China. FAU - Zhang, L AU - Zhang L AD - Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China. FAU - Dong, L AU - Dong L AD - Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China. LA - chi PT - Journal Article PL - China TA - Zhonghua Bing Li Xue Za Zhi JT - Zhonghua bing li xue za zhi = Chinese journal of pathology JID - 0005331 RN - 0 (BCL2 protein, human) RN - 0 (BCL6 protein, human) RN - 0 (MYC protein, human) RN - 0 (Proto-Oncogene Proteins c-bcl-2) RN - 0 (Proto-Oncogene Proteins c-bcl-6) RN - 0 (Proto-Oncogene Proteins c-myc) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - China MH - Female MH - Gene Rearrangement MH - Humans MH - In Situ Hybridization, Fluorescence MH - *Lymphoma, Large B-Cell, Diffuse/drug therapy/genetics MH - Male MH - Middle Aged MH - Prognosis MH - *Proto-Oncogene Proteins c-bcl-2/genetics MH - *Proto-Oncogene Proteins c-bcl-6/genetics MH - *Proto-Oncogene Proteins c-myc/genetics MH - Retrospective Studies EDAT- 2022/02/15 06:00 MHDA- 2022/02/16 06:00 CRDT- 2022/02/14 02:15 PHST- 2022/02/14 02:15 [entrez] PHST- 2022/02/15 06:00 [pubmed] PHST- 2022/02/16 06:00 [medline] AID - 10.3760/cma.j.cn112151-20210826-00604 [doi] PST - ppublish SO - Zhonghua Bing Li Xue Za Zhi. 2022 Feb 8;51(2):120-125. doi: 10.3760/cma.j.cn112151-20210826-00604.