title: Dual expression of MYC and BCL2 proteins predicts worse outcomes in diffuse large B-cell lymphoma.
abstract: Recent studies suggested that MYC and BCL2 protein co-expression is an independent indicator of poor prognosis in diffuse large B-cell lymphoma. However, the immunohistochemistry protocols for dual-expression staining and the scoring cut-offs vary by study. Sixty-nine cases of diffuse large B-cell lymphoma were evaluated for MYC and BCL2 protein expression using various cut-offs that have been recommended in prior studies. Independent of the International Prognostic Index risk group, cases with dual protein expression of BCL2 and MYC using ≥50%/40% cut-offs and ≥70%/40% had significantly shorter overall survival than cases without. It was verified in this patient population that the use of BCL2 and MYC immunohistochemistry, performed with available in vitro diagnostic-cleared antibodies, provides rapid prognostic information in patients with de novo diffuse large B-cell lymphoma. This study has practical implications for diagnostic laboratories and serves as a guide for implementation in the setting of future clinical trials.
authors.affiliation: a Cleveland Clinic , Cleveland , OH , USA ;
authors.forename: Kelli M
authors.initials: KM
authors.lastname: Clark Schneider
authors.affiliation: b Ventana Medical Systems, Inc., Roche Group , Tucson , AZ , USA ;
authors.forename: Peter M
authors.initials: PM
authors.lastname: Banks
authors.affiliation: a Cleveland Clinic , Cleveland , OH , USA ;
authors.forename: Angela M B
authors.initials: AM
authors.lastname: Collie
authors.affiliation: a Cleveland Clinic , Cleveland , OH , USA ;
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Lanigan
authors.affiliation: c Department of Mathematics and Computer Science , John Carroll University, University Heights , OH , USA.
authors.forename: Elena
authors.initials: E
authors.lastname: Manilich
authors.affiliation: a Cleveland Clinic , Cleveland , OH , USA ;
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Durkin
authors.affiliation: a Cleveland Clinic , Cleveland , OH , USA ;
authors.forename: Brian T
authors.initials: BT
authors.lastname: Hill
authors.affiliation: a Cleveland Clinic , Cleveland , OH , USA ;
authors.forename: Eric D
authors.initials: ED
authors.lastname: Hsi
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016022:Case-Control Studies; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D015870:Gene Expression; D006801:Humans; D007150:Immunohistochemistry; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011241:Prednisone / Q000627:therapeutic use; D016016:Proportional Hazards Models; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000235:genetics* / Q000378:metabolism; D016271:Proto-Oncogene Proteins c-myc / Q000235:genetics* / Q000378:metabolism; D000069283:Rituximab; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D019253:Proto-Oncogene Proteins c-bcl-2; D016271:Proto-Oncogene Proteins c-myc; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: B-cell lymphoma; BCL2; IHC; MYC