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双打击弥漫性大B细胞淋巴瘤的临床特征与免疫表型

Clinical Features and Immunophenotypes of Double-Hit Diffuse Large B-Cell Lymphoma.

作者信息

Wu Cheng-Han, Gau Jyh-Pyng, Teng Chieh-Lin Jerry, Shih Yu-Hsuan, Su Yu-Chen, Wang Ren-Ching, Chen Tsung-Chih

机构信息

Division of Hematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan.

Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.

出版信息

Diagnostics (Basel). 2022 Apr 28;12(5):1106. doi: 10.3390/diagnostics12051106.

Abstract

Double-hit (DH) genetics induces a reduction in the complete remission (CR) and, consequently, in poor overall survival (OS) in diffuse large B-cell lymphoma (DLBCL) patients. Unfortunately, DH identification is time-consuming. Here, we retrospectively reviewed 92 newly diagnosed DLBCL patients, stratified them into the DH ( = 14) and non-DH groups ( = 78), and compared their clinical features and outcomes. The results revealed that the DH group had a higher percentage of bulky disease than the non-DH group (64.3% vs. 28.2%; = 0.013). More patients in the DH group tested positive for double expresser (DE) (50.0% vs. 21.8%; = 0.044). The three-year OS rates of patients with and without DH were 33.3% and 52.2%, respectively ( = 0.016). Importantly, advance stage and multiple comorbidities were correlated with a high mortality rate in multivariate analysis. Furthermore, by combining DE and the bulky disease, a specificity of 89.7% for DH prediction was achieved. In summary, DH genetics, not DE immunopositivity, could be a factor for an inferior OS in DLBCL. A combination of bulky disease and a positive DE immunophenotype could facilitate DH genetics prediction in newly diagnosed DLBCL patients.

摘要

双打击(DH)遗传学导致弥漫性大B细胞淋巴瘤(DLBCL)患者的完全缓解(CR)率降低,进而导致总生存期(OS)较差。不幸的是,DH的鉴定耗时。在此,我们回顾性分析了92例新诊断的DLBCL患者,将他们分为DH组(n = 14)和非DH组(n = 78),并比较了他们的临床特征和预后。结果显示,DH组的大包块病比例高于非DH组(64.3%对28.2%;P = 0.013)。DH组中双表达(DE)检测呈阳性的患者更多(50.0%对21.8%;P = 0.044)。有和没有DH的患者的三年OS率分别为33.3%和52.2%(P = 0.016)。重要的是,在多变量分析中,晚期和多种合并症与高死亡率相关。此外,通过结合DE和大包块病,DH预测的特异性达到了89.7%。总之,DH遗传学而非DE免疫阳性可能是DLBCL患者OS较差的一个因素。大包块病和DE免疫表型阳性相结合可以促进新诊断的DLBCL患者的DH遗传学预测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da8d/9139504/dd9960a27013/diagnostics-12-01106-g001.jpg

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