Sole rearrangement but not amplification of MYC is associated with a poor prognosis in patients with diffuse large B cell lymphoma and B cell lymphoma unclassifiable.

Rearrangement of MYC is associated with a poor prognosis in patients with diffuse large B cell lymphoma ( DLBCL) and B cell lymphoma unclassifiable ( BCLU), particularly in the setting of double hit lymphoma ( DHL). However, little is known about outcomes of patients who demonstrate MYC rearrangement without evidence of BCL2 or BCL6 rearrangement (single hit) or amplification (>4 copies) of MYC. We identified 87 patients with single hit lymphoma ( SHL), 22 patients with MYC-amplified lymphoma ( MYC amp) as well as 127 DLBCL patients without MYC rearrangement or amplification ( MYC normal) and 45 patients with DHL, all treated with either R- CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) or intensive induction therapy. For SHL and MYC amp patients, the 2-year progression-free survival rate ( PFS) was 49% and 48% and 2-year overall survival rate ( OS) was 59% and 71%, respectively. SHL patients receiving intensive induction experienced higher 2-year PFS (59% vs. 23%, P = 0·006) but similar 2-year OS as compared with SHL patients receiving R- CHOP. SHL DLBCL patients treated with R- CHOP, but not intensive induction, experienced significantly lower 2-year PFS and OS ( P < 0·001 for both) when compared with MYC normal patients. SHL patients appear to have a poor prognosis, which may be improved with receipt of intensive induction. [ABSTRACT FROM AUTHOR]