Adverse outcome in follicular lymphoma is associated with MYC rearrangements but not MYC extra copies

Summary Follicular lymphomas (FLs) with MYC rearrangements (MYC‐R) and extra copies of MYC (MYC‐EC) are rare and the prognosis impact is uncertain. We conducted a retrospective study including 321 FL patients, among whom 259 (81%) had no 8q24 alterations and 62 (19%) were assigned to 8qAlt. Forty‐fi...

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Bibliographic Details
Published in:British journal of haematology 2021-07, Vol.194 (2), p.382-392
Main Authors: Bussot, Lucile, Chevalier, Simon, Cristante, Justine, Grange, Béatrice, Tesson, Bruno, Deteix‐Santana, Clémence, Orsini‐Piocelle, Frédérique, Leyronnas, Cécile, Dupire, Sophie, Gressin, Rémy, Salles, Gilles, Bachy, Emmanuel, Emadali, Anouk, Valmary‐Degano, Séverine, Huet, Sarah, Lefebvre, Christine, Carras, Sylvain
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Chemotherapy
follicular lymphoma
Gene Duplication
Gene Rearrangement
Hematology
Humans
Lymphoma
Lymphoma, Follicular - diagnosis
Lymphoma, Follicular - genetics
Lymphoma, Follicular - therapy
Medical prognosis
Middle Aged
MYC
Prognosis
Progression-Free Survival
Proto-Oncogene Proteins c-myc - genetics
rearrangement
Retrospective Studies
Survival
transformation
Young Adult
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Summary:Summary Follicular lymphomas (FLs) with MYC rearrangements (MYC‐R) and extra copies of MYC (MYC‐EC) are rare and the prognosis impact is uncertain. We conducted a retrospective study including 321 FL patients, among whom 259 (81%) had no 8q24 alterations and 62 (19%) were assigned to 8qAlt. Forty‐five cases were classified as MYC‐EC and six as MYC‐R. MYC‐R patients were significantly older (P = 0·008), had higher follicular lymphoma international prognostic index (FLIPI) stage (P = 0·05) and β2‐microglobulin (β2m; P = 0·05). Among patients treated with immuno‐chemotherapy, four presented a MYC‐R and 25 a MYC‐EC. Univariate analysis showed the absence of significant difference between MYC‐EC and normal MYC (MYC‐NL) regarding progression‐free survival (PFS; HR1·3; 95% CI [0·4–1·6]) and specific overall survival (SOS; HR 1·6; 95% CI [0·4–5·7]). Those results were compared to data from the PRIMA trial. This confirmed that MYC‐EC had no impact on PFS (P = 0·86) or SOS (P = 0·9). Conversely, MYC‐R was associated with a trend to inferior outcome regarding PFS (HR : 6·1; 95% CI [2·2–17·1]; P = 0·00026), lymphoma‐related death (SOS; HR 13·6; 95% CI [2·9–65]; P = 0·00014) and risk of transformation (transformation‐free survival (TFS); HR 82·7; 95% CI [14·8–463·4]; P 
ISSN:0007-1048
1365-2141
DOI:10.1111/bjh.17550