Abstract
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.
Keywords:
BCL2; MYC; autologous stem cell transplant; double hit lymphoma; double protein lymphoma.
© 2016 John Wiley & Sons Ltd.
Publication types
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Clinical Trial, Phase III
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Randomized Controlled Trial
MeSH terms
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Adolescent
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Adult
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Aged
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Antibodies, Monoclonal, Murine-Derived / administration & dosage
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Antineoplastic Combined Chemotherapy Protocols / administration & dosage
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Autografts
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Combined Modality Therapy / methods
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Cyclophosphamide / administration & dosage
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Doxorubicin / administration & dosage
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Female
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Hematopoietic Stem Cell Transplantation / methods*
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Humans
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Lymphoma / mortality
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Lymphoma / therapy*
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Male
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Middle Aged
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Prednisone / administration & dosage
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Proto-Oncogene Proteins c-bcl-2
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Proto-Oncogene Proteins c-myc*
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Rituximab
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Treatment Outcome
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Vincristine / administration & dosage
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Young Adult
Substances
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Antibodies, Monoclonal, Murine-Derived
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Proto-Oncogene Proteins c-bcl-2
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Proto-Oncogene Proteins c-myc
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R-CHOP protocol
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Rituximab
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Vincristine
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Doxorubicin
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Cyclophosphamide
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Prednisone