Puvvada Soham D, Stiff Patrick J, Leblanc Michael, Cook James R, Couban Stephen, Leonard John P, Kahl Brad, Marcellus Deborah, Shea Thomas C, Winter Jane N, Li Hongli, Rimsza Lisa M, Friedberg Jonathan W, Smith Sonali M
University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA.
Loyola University Medical Center, Maywood, IL, USA.
Br J Haematol. 2016 Sep;174(5):686-91. doi: 10.1111/bjh.14100. Epub 2016 Apr 13.
Double hit lymphoma (DHL) and double protein-expressing (MYC, BCL2) lymphomas (DPL) fare poorly with R-CHOP (rituximab + cyclophosphamide, doxorubicin, vincristine, prednisolone); consolidative autologous stem cell transplant (ASCT) may improve outcomes. S9704, a phase III randomized study of CHOP +/-R with or without ASCT enabled evaluation of intensive consolidation. Immunohistochemistry (IHC) identified 27 of 198 patients (13·6%) with MYC overexpression; 20 (74%) harboured concurrent BCL2 overexpression. Four had DHL and 16 had DPL only. With median 127 months follow-up, there is a trend favouring outcomes after ASCT in DPL and MYC protein overexpressing patients, whereas all DHL patients have died irrespective of ASCT.
双打击淋巴瘤（DHL）和双蛋白表达（MYC、BCL2）淋巴瘤（DPL）采用R-CHOP方案（利妥昔单抗+环磷酰胺、多柔比星、长春新碱、泼尼松龙）治疗效果不佳；巩固性自体干细胞移植（ASCT）可能改善预后。S9704是一项关于CHOP±R联合或不联合ASCT的III期随机研究，能够评估强化巩固治疗。免疫组织化学（IHC）在198例患者中鉴定出27例（13.6%）MYC过表达；其中20例（74%）同时存在BCL2过表达。4例为DHL，16例仅为DPL。中位随访127个月，DPL和MYC蛋白过表达患者接受ASCT后预后有改善趋势，而所有DHL患者无论是否接受ASCT均已死亡。
