TREATMENT OUTCOMES AND CLINICAL RELEVANCE IN PATIENTS WITH DOUBLE EXPRESSOR DLBCL Sirapat Rungwittayatiwat1, Paisarn Boonsakan2, Pichika Chantrathammachart1, Teeraya Puavilai1, Sulada Pukiat1, Sithakom Phusanti1,3, Kochawan Boonyawat1, Pathawut Wacharapornin1, Pantep Angchaisuksiri1, Artit Ungkanont1,3, Suporn Chuncharunee1 Pimjai Niparuck1
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Keywords
diffuse large B cell lymphoma, double expressor lymphoma, GCB, non GCB, survival
Abstract
Background: Double-expressor lymphoma (DEL) was found accounting for 20- 30% of DLBCL. We conducted this study to analyze the survival, the clinical presentation and the factors associated with treatment outcomes in DEL-DLBCL.
Methods: A retrospective study of 291 patients diagnosed with DLBCL during January 2015 - December 2018.
Results: Of the 291 patients, median age was 63 years, germinal center B cell like DLBCL (GCB) and non-GCB subtypes were found in 32% and 68%, respectively. DEL was found in 46% of 264 patients with available immunohistochemistry staining for MYC protein. Patients with DEL was significantly more common in elderly patients (p= 0.017) and non-GCB subtype (p= 0.006). High serum lactate dehydrogenase (LDH) levels and high Ki-67 index were significantly found in DEL patients than those in non-DEL patients (p= 0.024 and p= 0.04, respectively). 3y-OS and 3y-DFS in DEL patients were shorter than those in non-DEL group, 58.7% versus 78.9% (p=0.026) and 58.4% versus 67.7% (p=0.343), respectively. Independent factors affecting both OS and DFS in DEL patients were ECOG 3-4, high LDH level, extranodal involvement> 1 site, DHL, high IPI and stage III-IV.
Conclusions: High incidence of DEL was observed in this study, especially in patients aged 60 years or older and non-GCB subtype. Patients with DEL showed dismal DFS and OS.
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