title: Clinical significance of co-expression of MYC and BCL2 protein in aggressive B-cell lymphomas treated with a second line immunochemotherapy.
abstract: The clinical significance of concurrent expression of MYC and BCL2 protein, known as "double-expressor lymphoma" (DEL), among patients with relapsed or refractory aggressive B-cell lymphomas, remains unclear. A retrospective analysis was performed of 38 patients treated with a salvage treatment consisting of rituximab, ifosfamide, etoposide, cytarabine and dexamethasone followed by consolidative high-dose chemotherapies. A total of 17 cases (45%) were categorized as DEL using immunohistochemical assay with a cut-off value of positivity of 40% for MYC and 50% for BCL2, respectively. DEL was associated with a lower overall response rate (35% vs 71%, p = 0.0481), worse 2-year progression-free survival (9% vs 67%, p = 0.001) and overall survival (35% vs 71%, p = 0.037). This analysis suggests that DEL is common among patients with relapsed/refractory aggressive B-cell lymphomas and that such patients require novel treatment strategies.
authors.affiliation: a Division of Hematology and Rheumatology , Department of Medicine ;
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Miura
authors.affiliation: a Division of Hematology and Rheumatology , Department of Medicine ;|b Division of Laboratory Medicine , Department of Pathology of Microbiology ;
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: a Division of Hematology and Rheumatology , Department of Medicine ;
authors.forename: Masaru
authors.initials: M
authors.lastname: Nakagawa
authors.affiliation: c Department of Pathology , Nihon University School of Medicine , Tokyo , Japan.
authors.forename: Asami
authors.initials: A
authors.lastname: Izu
authors.affiliation: c Department of Pathology , Nihon University School of Medicine , Tokyo , Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sugitani
authors.affiliation: a Division of Hematology and Rheumatology , Department of Medicine ;
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kurita
authors.affiliation: a Division of Hematology and Rheumatology , Department of Medicine ;
authors.forename: Masashi
authors.initials: M
authors.lastname: Sakagami
authors.affiliation: a Division of Hematology and Rheumatology , Department of Medicine ;
authors.forename: Shimon
authors.initials: S
authors.lastname: Ohtake
authors.affiliation: a Division of Hematology and Rheumatology , Department of Medicine ;
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Uchino
authors.affiliation: a Division of Hematology and Rheumatology , Department of Medicine ;
authors.forename: Atsuko
authors.initials: A
authors.lastname: Hojo
authors.affiliation: a Division of Hematology and Rheumatology , Department of Medicine ;
authors.forename: Hitomi
authors.initials: H
authors.lastname: Kodaira
authors.affiliation: a Division of Hematology and Rheumatology , Department of Medicine ;
authors.forename: Mai
authors.initials: M
authors.lastname: Yagi
authors.affiliation: a Division of Hematology and Rheumatology , Department of Medicine ;
authors.forename: Yujin
authors.initials: Y
authors.lastname: Kobayashi
authors.affiliation: a Division of Hematology and Rheumatology , Department of Medicine ;
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Iriyama
authors.affiliation: a Division of Hematology and Rheumatology , Department of Medicine ;
authors.forename: Sumiko
authors.initials: S
authors.lastname: Kobayashi
authors.affiliation: a Division of Hematology and Rheumatology , Department of Medicine ;
authors.forename: Satomi
authors.initials: S
authors.lastname: Kiso
authors.affiliation: a Division of Hematology and Rheumatology , Department of Medicine ;
authors.forename: Yukio
authors.initials: Y
authors.lastname: Hirabayashi
authors.affiliation: a Division of Hematology and Rheumatology , Department of Medicine ;
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hatta
authors.affiliation: a Division of Hematology and Rheumatology , Department of Medicine ;
authors.forename: Masami
authors.initials: M
authors.lastname: Takei
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D019008:Drug Resistance, Neoplasm; D005260:Female; D015870:Gene Expression; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism* / Q000401:mortality; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000235:genetics / Q000378:metabolism*; D016271:Proto-Oncogene Proteins c-myc / Q000235:genetics / Q000378:metabolism*; D012008:Recurrence; D019233:Retreatment; D016879:Salvage Therapy; D016896:Treatment Outcome
chemical_list: D019253:Proto-Oncogene Proteins c-bcl-2; D016271:Proto-Oncogene Proteins c-myc
keywords: BCL2; Diffuse large B-cell lymphoma; MYC; refractory counts; relapse