title: Does cell-of-origin or MYC, BCL2 or BCL6 translocation status provide prognostic information beyond the International Prognostic Index score in patients with diffuse large B-cell lymphoma treated with rituximab and chemotherapy? A systematic review.
abstract: We examined the additional prognostic value for survival of cell-of-origin, and MYC, BCL2 and BCL6 translocation status to that provided by the International Prognostic Index in newly-diagnosed diffuse large B-cell lymphoma (DLBCL) patients treated firstline with rituximab-containing immunochemotherapy. We searched Medline, Premedline, Embase, the Cochrane Library, Web of Science, and ISI Proceedings (2000-2015) and assessed study risk-of-bias using a prognostic study checklist. Forty-four studies of moderate-high risk of bias with 100-712 participants were included. Immunohistochemistry-determined cell-of-origin, and BCL2 and BCL6 translocation status added no additional prognostic value. Half of the studies on gene expression profiling-determined cell-of-origin and MYC translocation status found that germinal center B-cell-like (GCB) and no translocation were associated with better overall survival (OS) whereas the remaining studies found no effect of these covariates. Further studies are required to ensure that biological information assessed using newer technologies can be reliably used for studies that incorporate newer agents targeting distinct molecular abnormalities identified in high-risk DLBCL patients.
authors.affiliation: a National Guideline Alliance , Royal College of Obstetricians and Gynaecologists , London , UK.
authors.forename: Mia
authors.initials: M
authors.lastname: Schmidt-Hansen
authors.affiliation: a National Guideline Alliance , Royal College of Obstetricians and Gynaecologists , London , UK.
authors.forename: Sabine
authors.initials: S
authors.lastname: Berendse
authors.affiliation: b Department of Histopathology , University College London Hospital , London , UK.
authors.forename: Teresa
authors.initials: T
authors.lastname: Marafioti
authors.affiliation: c Department of Haematology , University College London Hospital , London , UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: McNamara
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000235:genetics; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2; D051560:Proto-Oncogene Proteins c-bcl-6; D000069283:Rituximab / Q000627:therapeutic use; D059467:Transcriptome; D014178:Translocation, Genetic
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D019253:Proto-Oncogene Proteins c-bcl-2; D051560:Proto-Oncogene Proteins c-bcl-6; D000069283:Rituximab
keywords: DLBCL; Prognosis; cell-of-origin; multivariate analyses; rearrangement; translocation