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Sex
Age
LDH
Number of
extranodal sites
Stage
Performance score
IPI category
B symptoms
36%
64%
36%
64%
27%
73%
64%
36%
45%
55%
64%
36%
45%
55%
64%
36%
36%
64%
8
6
8
6
6
6
9
5
7
7
12
2
8
4
4
10
3
9
57%
43%
57%
43%
50%
50%
64%
36%
50%
50%
86%
14%
67%
33%
29%
71%
25%
75%
96
95
65
126
85
90
140
49
93
98
162
27
113
61
136
53
59
116
50%
50%
34%
66%
49%
51%
74%
26%
49%
51%
86%
14%
65%
35%
72%
28%
34%
66%
Complete
remission
36%
50%
122
64%
28%
64%
48%
18%
43%
41%
0.57
0.23
0.38
0.54
0.97
0.16
0.45
0.003
0.88
0.034
Figure 1 . Overall survival (A and C) and event-free survival (B and D) of patients with
DLBCL according to the presence or absence of rearrangement of the c-MYC and BCL2
genes.
100
100
|
|
80
c-MYC+/BCL2+
70
|
60
||
c-MYC-/BCL2-/+
|||
50
c-MYC+/BCL2-
| | || |
||
||
| |
| |||| |
|| |
||
40
| |
|
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30
| || | |
|
|
|| |
|
20
||
|
| |
||
|
|
|
|
90
|
||
|
10
p=0.15
P-value
c-MYC/BCL2
C-MYCC-MYC+/BCL2-/+
C-MYC+/BCL2+
1
0.8
2
0.35 1.64
0.99 3.89
0.11
International
Prognostic Index
(IPI)
Low (0-2)
High (3-5)
1
3
2.04 4.17
80
||
|
|
|
70
60
c-MYC+/BCL2+
c-MYC+/BCL2c-MYC-/BCL2-/+
|
||
50
40
||
||| | ||
| | | | ||
|
| ||
| | ||
30
| |
||
| || |
<0.0001
|
|
20
|| |
|| ||
10
p=0.21
0
0
10
15
20
10
Years
15
20
Years
Conclusion
100
100
|
|
90
|
|
||
|
80
We identified 216 cases of DLBCL that met the study criteria, with a
male:female ratio of 1:1 and a median age at diagnosis of 66.1 years
(range, 20.4 to 90.3 years).
Based on rearrangement of the c-MYC and BCL2 genes, the cases were
classified into three groups: 11 cases (5%) were c-MYC+/BCL2+, 14 cases
(6.5%) were c-MYC+/BCL2- and 191 cases (88.5%) were c-MYC- with or
without BCL2 rearrangement.
No distinguishing histological features were identified among the cases
with c-MYC, or c-MYC and BCL2 rearrangements when compared with
cases lacking these cytogenetic abnormalities.
No significant differences in clinical characteristics were identified among
the three groups except for B-symptoms in the c-MYC+/BCL2- group
(Table 1).
A decreased complete remission rate and a trend towards worse survival
were identified in the c-MYC+/BCL2+ group.
4
7
4
7
3
8
7
4
5
6
7
4
5
6
7
4
4
7
90
Results
Male
Female
< 60
>= 60
Normal
High
<2
>= 2
I/II
III/IV
> 70
<= 70
Low (0-2)
High (3-5)
No
Yes
< 5cm
>=5cm
Event-free Survival(%)
Clinical features
80
c-MYC+/BCL2+
c-MYC-, c-MYC+/BCL2-
|
70
|
60
||
||
|
|
|
90
Event-free Survival(%)
Introduction
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50
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40
|| | | |
| ||
| | || |
|
|| |
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30
20
||
|
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||
|
10
||
p=0.057
70
60
10
Years
15
20
Patients with DLBCL having both the c-MYC and BCL2 rearrangements have
a poor complete remission rate and survival.
c-MYC+/BCL2+
c-MYC-, c-MYC+/BCL2-
||
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50
40
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| | || |
| |
| ||
| ||
||| ||
30
| ||
| ||
|
|
20
|| ||
10
||
||
|
|
p=0.08
10
Years
15
20