title: Outcomes of MYC-associated lymphomas after R-CHOP with and without consolidative autologous stem cell transplant: subset analysis of randomized trial intergroup SWOG S9704.
abstract: Double hit lymphoma (DHL) and double protein-expressing (MYC, BCL2) lymphomas (DPL) fare poorly with R-CHOP (rituximab + cyclophosphamide, doxorubicin, vincristine, prednisolone); consolidative autologous stem cell transplant (ASCT) may improve outcomes. S9704, a phase III randomized study of CHOP +/-R with or without ASCT enabled evaluation of intensive consolidation. Immunohistochemistry (IHC) identified 27 of 198 patients (13·6%) with MYC overexpression; 20 (74%) harboured concurrent BCL2 overexpression. Four had DHL and 16 had DPL only. With median 127 months follow-up, there is a trend favouring outcomes after ASCT in DPL and MYC protein overexpressing patients, whereas all DHL patients have died irrespective of ASCT.
authors.affiliation: University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA.
authors.forename: Soham D
authors.initials: SD
authors.lastname: Puvvada
authors.affiliation: Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Stiff
authors.affiliation: SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Leblanc
authors.affiliation: Pathology and Laboratory Medicine Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Cook
authors.affiliation: Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Stephen
authors.initials: S
authors.lastname: Couban
authors.affiliation: Weill Medical College of Cornell University, New york, NY, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Leonard
authors.affiliation: University of Wisconsin, Madison, WI, USA.
authors.forename: Brad
authors.initials: B
authors.lastname: Kahl
authors.affiliation: McMaster University, Margaret and Charles Juravinski Cancer Centre, Hamilton, ON, Canada.
authors.forename: Deborah
authors.initials: D
authors.lastname: Marcellus
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Shea
authors.affiliation: Northwestern University, Chicago, IL, USA.
authors.forename: Jane N
authors.initials: JN
authors.lastname: Winter
authors.affiliation: SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Hongli
authors.initials: H
authors.lastname: Li
authors.affiliation: University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Rimsza
authors.affiliation: James P. Wilmot Cancer Center, University of Rochester, Rochester, NY, USA.
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Friedberg
authors.affiliation: University of Chicago, Chicago, IL, USA.
authors.forename: Sonali M
authors.initials: SM
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D064592:Autografts; D003131:Combined Modality Therapy / Q000379:methods; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008223:Lymphoma / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D019253:Proto-Oncogene Proteins c-bcl-2; D016271:Proto-Oncogene Proteins c-myc; D000069283:Rituximab; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
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: BCL2; MYC; autologous stem cell transplant; double hit lymphoma; double protein lymphoma