A multicenter retrospective study on clinicopathological features, gene variation profiles and prognostic analysis of previously untreated diffuse large B - cell lymphoma
10.3760/cma.j.cn511374-20250303-00120
- VernacularTitle:一项关于初治弥漫大B细胞淋巴瘤临床病理特征、基因变异谱及预后分析的多中心回顾性研究
- Author:
Yongning JIANG
1
;
Jie ZHANG
;
Yaping ZHANG
;
Yi XIA
;
Yi MIAO
;
Haiwen NI
;
Jinning SHI
;
Xiaohui ZHANG
;
Min XU
;
Haiying HUA
;
Yun ZHUANG
;
Wenzhong WU
;
Maozhong XU
;
Xiaoyan XIE
;
Zhuxia JIA
;
Yuqing MIAO
;
Min ZHAO
;
Jianyong LI
;
Wenyu SHI
Author Information
1. 南通大学附属医院肿瘤科，南通 226001
- Publication Type:Journal Article
- Keywords:
Diffuse large B-cell lymphoma;
Genetic variations;
Prognostic analysis
- From:
Chinese Journal of Medical Genetics
2025;42(9):1069-1077
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the impact of age on the genetic variant spectrum and prognosis of patients with previously untreated Diffuse large B-cell lymphoma (DLBCL).Methods:A retrospective analysis was conducted on the clinical data and follow-up information of 254 previously untreated DLBCL patients from 14 hospitals in the Jiangsu Cooperative Lymphoma Group (JCLG) enrolled from July 2018 and July 2023. Following extraction of DNA from tumor tissue samples, next-generation sequencing (NGS) technique was employed to analyze the genetic variant spectrum of the DLBCL patients, with an evaluation of the relationship between age and genetic variants as well as prognosis. This study was approved by the Medical Ethics Committee of the Affiliated Hospital of Nantong University (Ethics No.: 2023-K048-01).Results:The median age of the 254 DLBCL patients was 62 years old, with 55% of patients aged 60 years or above. Clinical evaluation showed that younger (< 60 years) patients had higher complete response (CR) (70% vs. 59%), and objective response rate (ORR) (88% vs. 79%) than older patients, though the difference between the two groups was not statistically. Survival analysis indicated that both the five-year overall survival (OS) (82.7% vs. 71.7%, P=0.006) and progression-free survival (PFS) (70.6% vs. 50.2%, P<0.05) rates were significantly higher in younger patients. NGS showed that 99.6% of the patients harbored genetic variants, with PIM1, KMT2D, TP53, MYD88, and CD79B being the most common genes. Age significantly affected the variant frequency of certain genes, with MYC variants serving an adverse prognostic factor for OS in younger patients ( P=0.001), while TP53 ( P=0.024) and BCL2 ( P=0.002) variants significantly impacted OS in older patients. Prognostic analysis identified age ≥ 60 years ( HR=3.439, 95% CI=1.318~9.874), presence of B symptoms ( HR = 2.871, 95% CI=1.133~7.307), and elevated lactate dehydrogenase ( HR=3.528, 95% CI=1.231~10.66) as independent adverse prognostic factors. Conclusion:Age, genetic variants, and clinical factors may significantly affect the prognosis of the DLBCL patients. Younger patients have better survival compared to older patients. Variants of the MYC, BCL2, and TP53 genes are closely associated with poor prognosis.
