整合基因亚型与PET扫描监测以预测弥漫性大B细胞淋巴瘤的预后。
Integrating genetic subtypes with PET scan monitoring to predict outcome in diffuse large B-cell lymphoma.
作者信息
Mendeville Matías S, Janssen Jurriaan, Los-de Vries G Tjitske, van Dijk Erik, Richter Julia, Nijland Marcel, Roemer Margaretha G M, Stathi Phylicia, Hijmering Nathalie J, Bladergroen Reno, Pelaz Diego A, Diepstra Arjan, Eertink Corinne J, Burggraaff Coreline N, Kim Yongsoo, Lugtenburg Pieternella J, van den Berg Anke, Tzankov Alexandar, Dirnhofer Stefan, Dührsen Ulrich, Hüttmann Andreas, Klapper Wolfram, Zijlstra Josée M, Ylstra Bauke, de Jong Daphne
机构信息
Department of Pathology, Cancer Center Amsterdam, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands.
Department of Pathology, Hematopathology Section and Lymph Node Registry University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
出版信息
Nat Commun. 2025 Jan 2;16(1):109. doi: 10.1038/s41467-024-55614-y.
Next Generation Sequencing-based subtyping and interim- and end of treatment positron emission tomography (i/eot-PET) monitoring have high potential for upfront and on-treatment risk assessment of diffuse large B-cell lymphoma patients. We performed Dana Farber Cancer Institute (DFCI) and LymphGen genetic subtyping for the HOVON84 (n = 208, EudraCT-2006-005174-42) and PETAL (n = 204, EudraCT-2006-001641-33) trials retrospectively combined with DFCI genetic data (n = 304). For all R-CHOP treated patients (n = 592), C5/MCD- and C2/A53-subtypes show significantly worse outcome independent of the international prognostic index. For all subtypes, adverse prognostic value of i/eot-PET-positive status is confirmed. Consistent with frequent primary refractory disease, only 67% C2 patients become eot-PET-negative versus 81-88% for other subtypes. Indicative of high relapse rates, outcome of C5 i/eot-PET-negative patients remains significantly worse in HOVON-84, which trend validates in the PETAL and SAKK38-07 trials (NCT00544219). These results show the added value of integrated genetic subtyping and PET monitoring for prognostic stratification and subtype-specific trial design.
基于新一代测序的亚型分类以及治疗中期和末期正电子发射断层扫描（i/eot-PET）监测在弥漫性大B细胞淋巴瘤患者的初始和治疗期间风险评估方面具有很高的潜力。我们对HOVON84试验（n = 208，EudraCT-2006-005174-42）和PETAL试验（n = 204，EudraCT-2006-001641-33）进行了达纳-法伯癌症研究所（DFCI）和LymphGen基因亚型分类，并回顾性地结合了DFCI基因数据（n = 304）。对于所有接受R-CHOP治疗的患者（n = 592），C5/MCD亚型和C2/A53亚型显示出明显更差的预后，与国际预后指数无关。对于所有亚型，i/eot-PET阳性状态的不良预后价值得到证实。与频繁出现的原发性难治性疾病一致，只有67%的C2亚型患者在治疗末期PET变为阴性，而其他亚型的这一比例为81%-88%。C5亚型i/eot-PET阴性患者在HOVON-84试验中的预后仍然明显更差，这表明复发率很高，该趋势在PETAL试验和SAKK38-07试验（NCT00544219）中得到验证。这些结果显示了综合基因亚型分类和PET监测在预后分层和亚型特异性试验设计中的附加价值。
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