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Upfront autologous hematopoietic stem cell transplantation for high-risk patients with double-expressor diffuse large B cell lymphoma

 Yu Ri Kim  ;  Sun Och Yoon  ;  Soo-Jeong Kim  ;  June-Won Cheong  ;  Haerim Chung  ;  Jung Yeon Lee  ;  Ji Eun Jang  ;  Yundeok Kim  ;  Woo-Ick Yang  ;  Yoo Hong Min  ;  Jin Seok Kim 
 ANNALS OF HEMATOLOGY, Vol.99(9) : 2149-2157, 2020-09 
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Adult ; Antineoplastic Combined Chemotherapy Protocols / therapeutic use ; Cyclophosphamide / therapeutic use ; Doxorubicin / therapeutic use ; Female ; Gene Expression Regulation, Neoplastic* ; Hematopoietic Stem Cell Transplantation / methods* ; Humans ; Lymphoma, Large B-Cell, Diffuse / diagnosis ; Lymphoma, Large B-Cell, Diffuse / genetics* ; Lymphoma, Large B-Cell, Diffuse / therapy* ; Male ; Middle Aged ; Prednisone / therapeutic use ; Proto-Oncogene Proteins c-bcl-2 / biosynthesis ; Proto-Oncogene Proteins c-bcl-2 / genetics* ; Proto-Oncogene Proteins c-myc / biosynthesis ; Proto-Oncogene Proteins c-myc / genetics* ; Retrospective Studies ; Risk Factors ; Transplantation, Autologous / methods ; Vincristine / therapeutic use ; Young Adult
Autologous hematopoietic stem cell transplantation ; BCL2 expression ; Diffuse large B cell lymphoma ; Double-expressor lymphoma ; MYC expression
Although MYC and BCL2 co-expression in diffuse large B cell lymphoma (DLBCL) is associated with inferior prognosis, it remains uncertain whether upfront autologous hematopoietic stem cell transplantation (ASCT) is beneficial in this lymphoma. This study aimed to investigate whether ASCT consolidation could have a positive role for patients with MYC and BCL2 co-expression (double-expressor lymphoma, DEL). We retrospectively evaluated 67 DLBCL patients who underwent upfront ASCT following rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy. The 5-year overall survival (OS) and progression-free survival (PFS) were 82.3% and 79.2%, respectively. There were 23 (34.3%) patients with DEL and 51 (76.1%) patients with non-germinal center B cell (GCB) subtype. The 5-year OS and PFS of patients with DEL were not different from those with non-DEL (P = 0.429 and P = 0.614, respectively). No survival difference for OS and PFS was also observed between GCB and non-GCB subtypes (P = 0.950 and P = 0.901, respectively). The OS and PFS were comparable for patients with DEL and non-DEL and both GCB and non-GCB subtypes. In conclusion, MYC and BCL2 co-expression did not have a poor prognostic impact among high-risk patients with DLBCL treated with upfront ASCT regardless of molecular classification. This preliminary study suggested that the role of consolidative ASCT is needed to be evaluated in a prospective randomized clinical trial.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Soo Jeong(김수정) ORCID logo https://orcid.org/0000-0001-8859-3573
Kim, Yu Ri(김유리) ORCID logo https://orcid.org/0000-0001-5505-0142
Kim, Yun Deok(김윤덕) ORCID logo https://orcid.org/0000-0002-5336-7936
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
Min, Yoo Hong(민유홍) ORCID logo https://orcid.org/0000-0001-8542-9583
Yang, Woo Ick(양우익) ORCID logo https://orcid.org/0000-0002-6084-5019
Yoon, Sun Och(윤선옥) ORCID logo https://orcid.org/0000-0002-5115-1402
Lee, Jung Yoen(이정연)
Jang, Ji Eun(장지은) ORCID logo https://orcid.org/0000-0001-8832-1412
Cheong, June-Won(정준원) ORCID logo https://orcid.org/0000-0002-1744-0921
Chung, Hae Rim(정해림) ORCID logo https://orcid.org/0000-0002-7926-9285
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