MYC translocation partner gene determines survival of patients with large B-cell lymphoma with MYC- or double-hit MYC/ BCL2 translocations.

In large B-cell lymphoma ( LBCL) MYC- and MYC/ BCL2 double-hit ( DH) translocations have been associated with inferior survival. We hypothesised that the negative prognostic impact of MYC translocation was determined by an immunoglobulin MYC translocation partner gene ( IG- MYC), as opposed to a non-immunoglobulin partner gene (non IG- MYC). In a prospective, unselected cohort of 237 LBCL patients MYC and BCL2 translocations were identified by Flourescent in situ hybridisation ( FISH) with split probes. MYC translocation partner gene was identified by IGH/ MYC fusion probes and/or kappa/lambda split probes. Clinical data were collected from patient files. MYC translocation was identified in 28/225 patients. IG- MYC translocation partner gene was identified in 12/24 patients. DH translocation was identified in 23/228 patients. IG- MYC translocation partner gene was identified in 9/19 DH patients. Neither MYC-nor DH translocation showed correlation with survival. However, MYC translocation with IG- MYC translocation partner gene was associated with worse OS compared with both MYC translocation with non IG- MYC translocation partner gene ( P = 0.02) as well as absence of MYC translocation ( P = 0.03). In patients with DH a similar, however, stronger correlation was seen ( P = 0.003 and P = 0.0004 respectively). MYC - or DH translocation with non IG- MYC translocation partner gene was not associated with worse overall survival ( P = 0.2 and P = 0.3 respectively). Most patients received Rituximab (86%) and CHOP/ CHOP-like chemotherapy regimes (81%). We suggest that prognostic stratification of LBCL patients by MYC and/or DH translocations should include identification of MYC translocation partner gene because approximately half of the cases harbour non IG- MYC translocation partner genes with no or minor influence on survival. [ABSTRACT FROM AUTHOR]