274P - Treatment stratification of non-Hodgkin large B-cell lymphoma patients based on the identification of mutational c-MYC gene

Background

B-cell lymphoma is associated with an aggressive clinical course, is prone to rapid growth and early progression. Studying gene expression profiles to identify molecular subgroups of lymphomas is a topical issue of haematology as it allows a personalized approach to treatment with high-dose polychemotherapy (PCT) regime with a monoclonal antibody. Such approach improves the immediate treatment efficacy and event-free survival rate. Purpose of the study was to increase the efficacy of therapy in patients with non-Hodgkin large B-cell lymphoma based on the examination of molecular genetic features of the tumor and the use of polychemotherapy based on mutational gene expression profile.

Methods

In this single-center prospective study, 44 patients with non-Hodgkin large B-cell lymphomas stages II-IV A & B were treated at the Department of Hemoblastosis at Kazakh Institute of Oncology and Radiology. Patients with mutated c-MYC gene were treated by high-dose PCT with R+HyperCVAD and we have analysed the treatment outcome.

Results

The FISH test revealed a mutation of c-MYC gene in non-Hodgkin large B-cell lymphoma patients. Therefore, these cases were classified as highly malignant and required high-dose PCT with a monoclonal antibody Rituximab followed by stem cell autotransplantation. This regime of PCT has improved the immediate efficacy of treatment. The patients (18 men and 26 women) were aged 27 to 58 years, with an average age of 42 years. B-cell lymphoma was confirmed in all cases; the complete response amounted to 80.0%; the disease-free survival (DFS) was 18 months (95% CI, 6.592-25.762, P = 0.003).

Conclusions

High-dose PCT in the R+HyperCVAD regimen (3-4 courses) followed by immunotherapy and autotransplantation of hemopoietic stem cells in patients with non-Hodgkin B-cell lymphoma have improved the immediate efficacy and long-term results of treatment of B-cell non-Hodgkin lymphoma.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Kazakh Institute of Oncology and Radiology.

Disclosure

All authors have declared no conflicts of interest.