MYC and BCL-2 protein co-expression and prognosis of patients with diffuse large B-cell lymphoma: a propensity score matching analysis.
10.3760/cma.j.issn.0253-2727.2022.01.009
- Author:
Jing ZHAN
1
;
Shi Jie YANG
1
;
Wei ZHANG
1
;
Dao Bin ZHOU
1
;
Yan ZHANG
1
;
Wei WANG
1
;
Chong WEI
1
Author Information
1. Department of Hematology, Chinese Academy of Medical Science & Peking Union Medical College, Peking Union Medical College Hospital, Beijing 100730, China.
- Publication Type:Journal Article
- Keywords:
BCL-2;
Lymphoma, large B cell, diffuse;
MYC;
Prognosis;
Propensity score matching
- MeSH:
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*;
Doxorubicin/therapeutic use*;
Humans;
Lymphoma, Large B-Cell, Diffuse/drug therapy*;
Prognosis;
Propensity Score;
Proto-Oncogene Proteins c-bcl-2;
Proto-Oncogene Proteins c-myc;
Retrospective Studies;
Rituximab/therapeutic use*;
Vincristine/therapeutic use*
- From:
Chinese Journal of Hematology
2022;43(1):41-47
- CountryChina
- Language:Chinese
-
Abstract:
Objective: We investigated the impact of MYC/BCL-2 protein co-expression on the prognosis of diffuse large B-cell lymphoma (DLBCL) patients and observed whether double expression (DE) remains an independent poor prognostic factor in DLBCL after the addition of therapeutic factors such as DA-EPOCH-R, central prophylaxis, and transplantation. Methods: Available pathological findings were retrospectively collected from 223 DLBCL patients at the Peking Union Medical College Hospital from 2015 to 2018. Seventy-five patients with high MYC/BCL-2 expression were categorized as the DE group. From the 148 non-DE patients, 75 DLBCL patients were selected as the control group, using a 1∶1 matching on propensity scores for age, international prognostic index score, treatment choice, and etc. The differences in overall survival (OS) and progression-free survival (PFS) between the two groups were compared. Results: The 3-year OS was (69.8±5.5) % for the DE group and (77.0±4.9) % for the non-DE group (P=0.225) , while the 3-year PFS was (60.7±5.8) % and (65.3±5.5) % , respectively (P=0.390) . Subgroup analysis in patients treated with the R-CHOP regimen revealed that for the DE and non-DE patients, the 3-year OS was (61.3±7.5) % and (77.2±5.6) % (P=0.027) , and the 3-year PFS was (52.1±7.5) % and (70.6±6.0) % (P=0.040) , respectively. Multivariate analysis showed that age, stage of Ann Arbor, COO staging, whether central prophylaxis was performed, and whether transplantation was performed were significant independent risk factors of the prognosis of DLBCL patients (P<0.05) . On the other hand, MYC/BCL-2 protein double expression was not significantly associated with prognostic outcomes. Conclusion: MYC/BCL-2 protein double expression was significantly associated with poor prognosis under R-CHOP regimen treatment, but the poor prognostic impact of DE on DLBCL was eliminated under intensive regimens such as DA-EPOCH-R and transplantation.
