Immunohistochemical double hit score enhances <scp>NCCN</scp>–<scp>IPI</scp> and is associated with detrimental outcomes in refractory or relapsing patients with diffuse large B cell lymphoma

Prochazka, Katharina; Posch, Florian; Deutsch, Alexander; Beham‐Schmid, Christine; Stöger, Herbert; Abdyli, Leke; Greinix, Hildegard; Pichler, Martin; Neumeister, Peter

doi:10.1111/bjh.14912

Cited by 5 publications

(7 citation statements)

References 3 publications

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“…Recently, the National Comprehensive Cancer Network (NCCN)-IPI has been introduced as a more meaningful prognostic parameter than the traditional IPI for newly diagnosed DLBCL cases [4]. A recent study has shown that a higher NCCN-IPI is significantly associated with a low overall response rate and poor survival in relapsed or refractory DLBCL [5]. However, further research is needed to confirm whether NCCN-IPI specifies clinical outcomes in the relapsed or refractory setting.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, cell of origin (COO) subtype in relapsed or refractory DLBCL has also been noticed as a prominent prognostic biomarker for survival prediction since DLBCL cases differ in their cellular compositions [5]. However, gene expression profiling or immunohistochemical analysis to determine COO has not been widely implemented in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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Clinical impacts of inflammatory markers and clinical factors in patients with relapsed or refractory diffuse large B-cell lymphoma

et al. 2019

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BackgroundSystemic inflammatory response can be associated with the prognosis of diffuse large B cell lymphoma (DLBCL). We investigated the systemic factors significantly related to clinical outcome in relapsed/refractory DLBCL.MethodsIn 242 patients with DLBCL, several factors, including inflammatory markers were analyzed. We assessed for the correlation between the survivals [progression-free survival (PFS) and overall survival (OS)] and prognostic factors.ResultsIn these patients, a high derived neutrophil/lymphocyte ratio (dNLR) (PFS, HR=2.452, P=0.002; OS, HR=2.542, P=0.005), high Glasgow Prognostic Score (GPS) (PFS, HR=2.435, P=0.002; OS, HR=2.621, P=0.002), and high NCCN-IPI (PFS, HR=2.836, P=0.003; OS, HR=2.928, P=0.003) were significantly associated with survival in multivariate analysis. Moreover, we proposed a risk stratification model based on dNLR, GPS, and NCCN-IPI, thereby distributing patients into 4 risk groups. There were significant differences in survival among the 4 risk groups (PFS, P<0.001; OS, P<0.001).ConclusionIn conclusion, dNLR, GPS, and NCCN-IPI appear to be excellent prognostic parameters for survival in relapsed/refractory DLBCL.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical impacts of inflammatory markers and clinical factors in patients with relapsed or refractory diffuse large B-cell lymphoma

et al. 2019

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“…The most common histologic phenotype of POL is DLBCL, which is thought to have a good prognosis by most researchers [4,10]. The expression pattern of CD10, Bcl-6 and Mum-1 by immunohistochemistry can be used to categorize DLBCL into germinal center B-cell-like lymphoma (GCB) DLBCL and non-GCB DLBCL.…”

Section: Discussionmentioning

confidence: 99%

Primary Diffuse Large B-Cell Lymphoma of Ovary: Report of Cases and Literature Review

XF¹,

XL²,

YT³

et al. 2022

annhematoloncol

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Objective: Our study aimed to review the characters of primary diffuse large B-cell lymphoma (DLBCL) of ovary and provide recommendations of management for this rare disease. Methods: We presented 4 cases of primary ovarian DLBCL (PODLBCL) from Beijing Chaoyang Hospital between 2003 and 2021. Furthermore, we searched PubMed and Web of Science database for literature published between 1998 and 2021.A total of 16 articles included 24 cases with histopathologically confirmed PODLBCL and detailed evaluation and follow-up were reviewed. Results: The median age of patients with PODLBCL was 43y (5-73y). The main clinical symptoms were pelvic mass, abdominal pain, followed by irregular vaginal bleeding and urinary incontinence. 25% patients had bilateral ovarian tumors, and 61.1% of unilateral tumors were in the left ovary. Cancer antigen 125 (CA125) and serum lactate dehydrogenase (LDH) were usually elevated to varying degrees. Most cases were diagnosed by surgery and presented in early stage. Treatments included surgery, chemotherapy and monoclonal antibody therapy. There was no evidence of recurrence within a median follow-up time of 20 months (range 5-72 months) in 79.1% (19/21) of patients. Conclusions: PODLBCL had no significantly specific character to distinguish from ovarian epithelial malignant tumors. The prognosis of patients with PODLBCL was usually good. We proposed that chemotherapy combined with monoclonal antibody therapy may be the first-line treatment for PODLBCL, and surgical resection of the tumor may be avoided. The key problem is how to make an early preoperative diagnosis. Therefore, more case reports and institutional studies are needed to confirm these conclusions.

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“…BCL2 and c‐Myc status were assessed as previously described . Briefly, FFPE tumor tissue was stained using the UltraVision LP HRP Polymer detection system (ThermoFisher, Fremont, California; primary antibody for BCL2: Clone 124; dilution 1:200, Dako, Glostrup, Denmark; primary antibody for c‐Myc: Clone Y69, dilution 1:200, Biocare Medical, Concord).…”

Section: Methodsmentioning

confidence: 99%

“…BCL2 and c-Myc status were assessed as previously described. 14 Staining results were scored based on the algorithm of Green et al Thus, IHC expression of BCL2 < 70% and MYC < 30% was assigned a double hit score (DHS) of 0, expression of BCL2 ≥ 70% or MYC≥30% a DHS of 1, and expression of BCL2 ≥ 70% and MYC≥30% a DHS of 2, respectively. 12 Cox model, respectively.…”

Section: Immunohistochemical Assessment Of Bcl2 and C-mycmentioning

confidence: 99%

Immunohistochemistry for c‐myc and bcl‐2 overexpression improves risk stratification in primary central nervous system lymphoma

Hatzl

Posch

Deutsch

et al. 2020

Hematological Oncology

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Overexpression of bcl‐2 and c‐myc are defining features of double‐expressor‐lymphoma (DEL) but may also occur separately in patients with primary central nervous system lymphoma (PCNSL). Despite all progress in optimizing treatment regimen, there is lack of sufficient risk stratification models. Here, we first describe the relationship between DEL biology, the National Comprehensive Cancer Network International Prognostic Index (NCCN‐IPI), treatment response, disease progression, and mortality in PCNSL. In this study, we determined c‐myc and bcl‐2 status immunohistochemically in samples of 48 patients with newly diagnosed PCNSL and followed these patients for a median interval of 6.2 years. Twelve, 18, and 17 patients harbored none, one, or both DEL features. Corresponding overall response rates after first‐line therapy were strongly associated with DEL biology (100%, 42%, and 44% in patients with 0, 1, or 2 DEL features). Patients with one or both DEL features had a 5‐fold and 13‐fold higher 5‐year risk of progression and/or death than patients without DEL features. These associations prevailed after adjusting for the NCCN‐IPI. DEL improved the discriminatory capability of the NCCN‐IPI ( P = .0001). Furthermore, we could show that addition of DEL biology to the NCCN‐IPI significantly improved the score's discriminatory potential both toward progression‐free survival (increase in Harell's c = 0.15, P = .005) and overall survival (increase in Harell's c = 0.11, P = .029). In conclusion, DEL biology is a strong and simple‐to‐use predictor of adverse outcome in PCNSL. Addition of DEL to the NCCN‐IPI improves its prognostic potential. Disease progression from PCNSL harboring both DEL features is invariably fatal. This defines a novel PCNSL patient subset with a great unmet need for improved therapy.

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Immunohistochemical double hit score enhances NCCN–IPI and is associated with detrimental outcomes in refractory or relapsing patients with diffuse large B cell lymphoma

Cited by 5 publications

References 3 publications

Clinical impacts of inflammatory markers and clinical factors in patients with relapsed or refractory diffuse large B-cell lymphoma

Clinical impacts of inflammatory markers and clinical factors in patients with relapsed or refractory diffuse large B-cell lymphoma

Primary Diffuse Large B-Cell Lymphoma of Ovary: Report of Cases and Literature Review

Immunohistochemistry for c‐myc and bcl‐2 overexpression improves risk stratification in primary central nervous system lymphoma

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