Abstract 5883
Background
Diffuse Large B-Cell Lymphoma is the most common type of Non-Hodgkin Lymphoma. Genetic studies have revealed that one of its molecular subtypes resistant to treatment by standard protocols occurs when there are concurrent translocations in the C-MYC and BCL2 or BCL6 genes constituting the type known as double hit lymphoma (DHL). Double expresser lymphoma (DEL) is another subtype that is much more frequent, including about 20-30% of cases. It occurs when there is protein overexpression of C-MYC together with BCL2 or BCL6 proteins without actual gene translocation.
Methods
Tissue microarray platform was constructed using cores from selected areas of each specimen. Hematoxylin and Eosin slides were reviewed for confirmation of pathologic diagnosis and immunohistochemistry was used for detection of C-MYC, BCL2 and BCL6 expression. Stained slides were assessed for percentage of cellular expression for each marker where median expression was used as the threshold value for defining positivity. DLBCL with high expression for MYC and BCL2 or BCL6 was defined as DEL.
Results
Tissue microarray blocks were constructed from the paraffin blocks of 87 cases with a confirmed diagnosis of DLBCL. Median age for participants was 58 years. CMYC, BCL2, and BCL6 showed high protein expression in 50.6% (n = 44), 55.2% (n = 48), and 54% (n = 47) respectively. Cases with DEL constituted 44.8% of sample (n = 39), where DEL was significantly higher in patients with poor performance status (PS > 1). Neither of the associations between DEL and other patients’ or disease’s characteristics (age, gender, smoking history, family history, comorbidities, B symptoms, LDH, B2 microglobulin, stage, BM infiltration, presence of more than one extranodal site, IPI, and risk group) tested positive. There were no associations between DEL and response, PFS, DFS, or OS.
Conclusions
DEL is not uncommon among studied sample constituting around 44.8% of cases. This positive protein expression was commonly found in patients with poor performance status creating a particular therapeutic challenge. DEL did not correlate with other variables including known prognostic factors for DLBCL. DEL did not also show effect on further treatment outcomes including response and survival.
Clinical trial identification
N/A
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5650 - Tissue-based activation of mucosal-associated invariant T (MAIT) cells in combination ipilimumab and nivolumab checkpoint inhibitor (CI) colitis.
Presenter: Sarah Sasson
Session: Poster Display session 3
Resources:
Abstract
5944 - Significance of severe immune-related adverse effects (irAE) on patients with advanced tumors treated with immune checkpoint inhibitors being admitted for secondary toxicity: Clinical relevance and next steps
Presenter: Leyre Zubiri
Session: Poster Display session 3
Resources:
Abstract
5989 - Implementation of a dedicated immuno-oncology toxicity service reduces the acute impact of immune-related adverse events
Presenter: Anna Olsson-Brown
Session: Poster Display session 3
Resources:
Abstract
3267 - Cardiotoxic and pro-inflammatory effects induced by the association of immune checkpoint inhibitor Pembrolizumab and Trastuzumab in preclinical models
Presenter: Nicola Maurea
Session: Poster Display session 3
Resources:
Abstract
3417 - Interstitial lung disease associated with immune-checkpoint inhibitors in malignant diseases
Presenter: Akira Yamagata
Session: Poster Display session 3
Resources:
Abstract
2071 - A Phase 1 Study of Intraperitoneal MCY-M11 Anti-Mesothelin CAR for Women with Platinum Resistant High Grade Serous Adenocarcinoma of the Ovary, Primary Peritoneum, or Fallopian Tube, or Subjects with Peritoneal Mesothelioma with Recurrence after Prior Chemotherapy
Presenter: Christina Annunziata
Session: Poster Display session 3
Resources:
Abstract
4935 - Trial in progress: First-in-human study of a novel anti-NY-ESO-1–anti-CD3, TCR-based bispecific (IMCnyeso) as monotherapy in NY-ESO-1/LAGE-1A-positive advanced solid tumors (IMCnyeso-101)
Presenter: Juanita Lopez
Session: Poster Display session 3
Resources:
Abstract
5613 - Nimotuzumab-Cisplatin-Radiation versus Cisplatin-Radiation in HPV negative oropharyngeal cancer
Presenter: Kumar Prabhash
Session: Poster Display session 3
Resources:
Abstract
2576 - Interim analysis of a single arm phase 2 study of adjuvant nivolumab after salvage resection in head and neck squamous cell carcinoma patients previously treated with definitive therapy.
Presenter: Trisha Wise-draper
Session: Poster Display session 3
Resources:
Abstract
4758 - A Phase I Study of the CDK4/6 Inhibitor, Palbociclib in combination with Cetuximab and Intensity Modulated Radiation Therapy (IMRT) for Locally Advanced Squamous Cell Carcinoma of the Head and Neck (SCCHN); A Result of Dose Escalation Cohort
Presenter: Nuttapong Ngamphaiboon
Session: Poster Display session 3
Resources:
Abstract