Diagnosis and treatment in patients with B-cell lymphoma unclassified that is intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphoma

Bariakh E.A.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Misyurina A.E.

Hematology Research Center, Ministry of Health of Russia, Moscow, Russia

Kovrigina A.M.

Nauchno-klinicheskoe otdelenie gematologicheskoĭ khirurgii Gematologicheskogo nauchnogo tsentra Minzdrava RF, Moskva

Obukhova T.N.

FGBU "Gematologicheskiĭ nauchnyĭ tsentr" Minzdrava Rossii, Moskva

Gemdzhyan E.G.

National Research Center for Hematology, Moscow, Russia

Vorob’ev V.I.

S.P. Botkin State Clinical Hospital, Moscow, Russia

Mangasarova Ia.K.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Polyakov Yu.Yu.

Hematology Research Center, Ministry of Health of Russia, Moscow, Russia

Magomedova A.U.

Federal Research and Clinical Center of Sports Medicine, Federal Biomedical Agency of the Russia, Moscow, Russia

Kliasova G.A.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii, Moskva

Misyurin V.A.

Hematology Research Center, Ministry of Health of Russia, Moscow, Russia

Iatsyk G.A.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii, Moskva

Shevelev A.A.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii, Moskva

Kostina I.É.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii, Moskva

Vorob'ev A.I.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Kravchenko S.K.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Diagnosis and treatment in patients with B-cell lymphoma unclassified that is intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphoma

Authors:

Bariakh E.A., Misyurina A.E., Kovrigina A.M., Obukhova T.N., Gemdzhyan E.G., Vorob’ev V.I., Mangasarova Ia.K., Polyakov Yu.Yu., Magomedova A.U., Kliasova G.A., Misyurin V.A., Iatsyk G.A., Shevelev A.A., Kostina I.É., Vorob'ev A.I., Kravchenko S.K.

More about the authors

Journal: Therapeutic Archive. 2015;87(8): 77‑85

DOI: 10.17116/terarkh201587877-85

Downloaded: 480

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Bariakh EA, Misyurina AE, Kovrigina AM, et al. . Diagnosis and treatment in patients with B-cell lymphoma unclassified that is intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphoma. Therapeutic Archive. 2015;87(8):77‑85. (In Russ.)
https://doi.org/10.17116/terarkh201587877-85

Close metadata

Recommended articles:

Efficacy of intensive therapy for massive intraoperative blood loss in children: experience of the Morozov Hospital. Pirogov Russian Journal of Surgery. 2024;(7):103-110

Aim. To characterize a group of patients with B-cell lymphoma (BCLU) unclassified that is intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphoma, to identify poor prognostic factors, and to evaluate therapeutic efficiency in patients with BCLU. Subjects and methods. Twenty-five patients with BCLU were examined. Double-hit lymphoma (DHL) was diagnosed in 8 (32%) patients. According to the Ann-Arbor classification of lymphoma, its stages II, III, and IV were diagnosed in 3 (12%), 2 (8%), and 20 (80%) patients, respectively. MYC rearrangement was observed in 11 (48%) out of 23 patients: single-hit lymphoma in 3 patients and DHL in 8 (BCL2+/MYC+ in 6 cases and BCL6+/MYC+ in 2). The expression of с-MYC (cut off ≥40%) was revealed in 17 (74%) out of 23 patients; that of BCL2 (cut off ≥50%) was detected in 14 (58%) out of 24 patients; coexpression of both proteins was seen in 12 (52%) out of 23 patients. The DHL group showed a correlation between the rearrangement of the BCL2+/MYC+ genes and the expression of MYC and BCL2 proteins in 5 out of 6 patients. Taking into account the heterogeneity of the entire patient group, DHL and non-DHL subgroups were considered separately. Both subgroups were comparable by clinical characteristics. BCLU patients younger than 60 years of age received treatment according to the LB-M-04 ± rituximab; those aged 60 or older had CHOP-like regimens ± rituximab. Autologous stem cell transplantation (auto-SCT) was performed in 5 patients belonging to a high-risk group. Results. The 3-year overall survival (OS) was 62% and the 3-year event-free survival (EFS) was 51%. The 3-year OS was lower for the DHL group than that for the non-DHL group (43 and 75%, respectively). Conclusion. In the DHL group, both OS and EFS are significantly lower (the risk of poor outcome, including death, is higher) than those in the non-DHL group. It is conceivable that intensified chemotherapy with auto-SCT increases treatment results in patients with BCLU; however, a larger number of observations are needed to obtain valid data.

Keywords:

B-cell lymphoma unclassified

double-hit lymphoma

intensive therapy

autologous stem cell transplantation

Authors:

Bariakh E.A.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Misyurina A.E.

Hematology Research Center, Ministry of Health of Russia, Moscow, Russia

Kovrigina A.M.

Nauchno-klinicheskoe otdelenie gematologicheskoĭ khirurgii Gematologicheskogo nauchnogo tsentra Minzdrava RF, Moskva

Obukhova T.N.

FGBU "Gematologicheskiĭ nauchnyĭ tsentr" Minzdrava Rossii, Moskva

Gemdzhyan E.G.

National Research Center for Hematology, Moscow, Russia

Vorob’ev V.I.

S.P. Botkin State Clinical Hospital, Moscow, Russia

Mangasarova Ia.K.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Polyakov Yu.Yu.

Hematology Research Center, Ministry of Health of Russia, Moscow, Russia

Magomedova A.U.

Federal Research and Clinical Center of Sports Medicine, Federal Biomedical Agency of the Russia, Moscow, Russia

Kliasova G.A.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii, Moskva

Misyurin V.A.

Hematology Research Center, Ministry of Health of Russia, Moscow, Russia

Iatsyk G.A.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii, Moskva

Shevelev A.A.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii, Moskva

Kostina I.É.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii, Moskva

Vorob'ev A.I.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Kravchenko S.K.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

List of references:

Kluin PM, Harris NL, Stein H, Leoncini L, Raphael M, Campo E, Jaffe ES. B-cell lymphoma, unclassifiable with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma in Who Classification of tumors of haematopoietic and lymphoid tissues, edited by SH Swerdlow, E Campo, NL Harris, ES Jaffe, SA Pileri, H Stein, J Thiele, JW Vardiman. 2008:265-266.
Jaffe ES, Pittaluga S. Aggressive B-cell lymphomas: a review of new and old entities in the WHO classification. Hematology. Am Soc Hematol Educ Program. 2011;2011:506-514.
Hasserjian RP, Ott G, Elenitoba-Johnson KS, Balague-Ponz O, de Jong D, de Leval L. Commentary on the WHO classification of tumors of lymphoid tissues (2008): «Gray zone» lymphomas overlapping with Burkitt lymphoma or classical Hodgkin lymphoma. J Hematopathol. 2009;2:89-95.
Baryakh E.A., Kravchenko S.K., Obukhova T.N., Zvonkov E.E., Kremenetskaya A.M., Klyasova G.A., Terekhova A.Yu., Vorob'ev A.I. Limfoma Berkitta: klinika, diagnostika, lechenie. Klinicheskaya onkogematologiya. Fundamental'nye issledovaniya i klinicheskayapraktika. 2009;2(2):137-146.
Baryakh E.A., Kravchenko S.K., Kremenetskaya A.M., Zvonkov E.E., Magomedova A.U., Obukhova T.N., Popova Yu.Yu., Fink O.S., Klyasova G.A., Shulutko E.M., Galstyan G.M., Kaplanskaya I.B., Vorob'ev I.A., Vorob'ev A.I. Leikoz/limfoma Berkitta: klinicheskie osobennosti, diagnosticheskie kriterii, terapevticheskaya taktika. Klinicheskaya onkogematologiya. Fundamental'nye issledovaniya i klinicheskaya praktika. 2010;3(2):138-143.
Kravchenko SK, Baryakh EA, Zamyatina VI, Perestoronina TN, Fink OS, Gubkin AV, Egorova EK, Zvonkov EE, Ilyushkina EA, Krasilnikova BB, Morozova AK, Vorobyev IA, Kaplanskaya IB, Klyasova GA, Obukhova TN, Kremenetskaya AM, Vorobyev AI. High-dose therapy of burkitt’s lymphoma in patients over 40 years of age. Terapevticheskii arkhiv. 2008;7:9-18.
Hans CP, Weisenburger DD, Greiner TC, Gascoyne RD, Delabie J, Ott G, Müller-Hermelink HK, Campo E, Braziel RM, Jaffe ES, Pan Z, Farinha P, Smith LM, Falini B, Banham AH, Rosenwald A, Staudt LM, Connors JM, Armitage JO, Chan WC. Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood. 2004;103:275-282.
Kanungo A, Medeiros LJ, Abruzzo LV, Lin P. Lymphoid neoplasms associated with concurrent t(14;18) and 8q24/c-MYC translocation generally have a poor prognosis. Modern Pathology. 2006;19:25-33.
Le Gouill S, Talmant P, Touzeau C, Moreau A, Garand R, Juge-Morineau N, Gaillard F, Gastinne T, Milpied N, Moreau P, Harousseau JL, Avet-Loiseau H. The clinical presentation and prognosis of diffuse large B-cell lymphoma with t(14;18) and 8q24/c-MYC rearrangement. Haematologica. 2007;92:1335-1342.
Tomita N, Tokunaka M, Nakamura N, Takeuchi K, Koike J, Motomura S, Miyamoto K, Kikuchi A, Hyo R, Yakushijin Y, Masaki Y, Fujii S, Hayashi T, Ishigatsubo Y, Miura I. Clinicopathological features of lymphoma/leukemia patients carrying both BCL2 and MYC translocations. Haematologica. 2009;94(7):935-943.
Johnson NA, Savage KJ, Ludkovski O, Ben-Neriah S, Woods R, Steidl C, Dyer MJ, Siebert R, Kuruvilla J, Klasa R, Connors JM, Gascoyne RD, Horsman DE. Lymphomas with concurrent BCL2 and MYC translocations: the critical factors associated with survival. Blood. 2009;114:2273-2279.
Niitsu N, Okamoto M, Miura I, Hirano M. Clinical features and prognosis of de novo diffuse large B-cell lymphoma with t(14;18) and 8q24/c-MYC translocations. Leukemia. 2009;23:777-783.
Snuderl M, Kolman OK, Chen YB, Hsu JJ, Ackerman AM, Dal Cin P, Ferry JA, Harris NL, Hasserjian RP, Zukerberg LR, Abramson JS, Hochberg EP, Lee H, Lee AI, Toomey CE, Sohani AR. B-cell lymphomas with concurrent IGH-BCL2 and MYC rearrangements are aggressive neoplasms with clinical and pathologic features distinct from Burkitt lymphoma and diffuse large B-cell lymphoma. Am J Surg Pathol. 2010;34(3):327-340.
Greenwood M, Armytage T, Fay K. Outcomes of allogeneic stem cell transplantation for non-Hodgkin lymphoma with concurrent MYC and BCL2 translocations: a single center retrospective analysis. Hematol Oncol. 2013;3(Suppl. 1):103.
Oki Y, Noorani M, Davis RE, Davis RE, Neelapu SS, Ma L, Ahmed M, Rodriguez MA, Hagemeister FB, Fowler N, Wang M, Fanale MA, Nastoupil L, Samaniego F, Lee HJ, Dabaja BS, Pinnix CC, Medeiros LJ, Nieto Y, Khouri I, Kwak LW, Turturro F, Romaguera JE, Fayad LE, Westin JR. Double hit lymphoma: M.D. Anderson Experince. Blood. 2013;122(21):1776.
Sun H, Savage K, Karsan A. Outcome of patients wits double-hit lymphomas treated with CODOX-M/IVAC + R followed by hematopoietic stem cell transplantation in British Columbia. Blood. 2013;122(21):1788.
Petrich AM, Gandhi M, Jovanovic B, Castillo JJ, Rajguru S, Yang DT, Shah KA, Whyman JD, Lansigan F, Hernandez-Ilizaliturri FJ, Lee LX, Barta SK, Melinamani S, Karmali R, Adeimy C, Smith S, Dalal N, Nabhan C, Peace D, Vose J, Evens AM, Shah N, Fenske TS, Zelenetz AD, Landsburg DJ, Howlett C, Mato A, Jaglal M, Chavez JC, Tsai JP, Reddy N, Li S, Handler C, Flowers CR, Cohen JB, Blum KA, Song K, Sun HL, Press O, Cassaday R, Jaso J, Medeiros LJ, Sohani AR, Abramson JS. Impact of induction regimen and stem cell transplantation on outcomes in double-hit lymphoma: a multicenter retrospective analysis. Blood. 2014;124(15): 2354-2361.
Aukema SM, Siebert R, Schuuring E, van Imhoff GW, Kluin-Nelemans HC, Boerma EJ, Kluin PM. Double-hit B-cell lymphomas. Blood. 2011;117(8):2319-2931.
Hoeller S, Copie-Bergman C. Grey Zone Lymphomas: Lymphomas with Intermediate Features. Advances in Hematology. 2012, article ID 460801.
Tauro S, Cochrane L, Lauritzsen GF, Baker L, Delabie J, Roberts C, Mahendra P, Holte H. Dose-intensified treatment of Burkitt lymphoma and B-cell lymphoma unclassifiable (with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma) in young adults (<50 years): A comparison of two adapted BFM protocols. Am J Hematol. 2010;85(4):261-263.
Kobayashi T, Tsutsumi Y, Sakamoto N, Nagoshi H, Yamamoto-Sugitani M, Shimura Y, Mizutani S, Matsumoto Y, Nishida K, Horiike S, Asano N, Nakamura S, Kuroda J, Taniwaki M. Double-hit Lymphomas Constitute a Highly Aggressive Subgroup in Diffuse Large B-cell Lymphomas in the Era of Rituximab. Jpn J Clin Oncol. 2012;42(11):1035-1042.
Aukema SM, Kreuz M, Kohler CW, Rosolowski M, Hasenclever D, Hummel M, Küppers R, Lenze D, Ott G, Pott C, Richter J, Rosenwald A, Szczepanowski M, Schwaenen C, Stein H, Trautmann H, Wessendorf S, Trümper L, Loeffler M, Spang R, Kluin PM, Klapper W, Siebert R. Biological characterization of adult MYC-translocation-positive mature B-cell lymphomas other than molecular Burkitt lymphoma. Haematologica. 2014;99(4):726-735.
Valera A, López-Guillermo A, Cardesa-Salzmann T, Climent F, González-Barca E, Mercadal S, Espinosa I, Novelli S, Briones J, Mate JL, Salamero O, Sancho JM, Arenillas L, Serrano S, Erill N, Martínez D, Castillo P, Rovira J, Martínez A, Campo E, Colomo L, Grup per l’Estudi dels Limfomes de Catalunya i Balears (GELCAB). MYC Protein Expression And Genetic Alterations Have Prognostic Impact In Patients With Diffuse Large B-Cell Lymphoma Treated With Immunochemotherapy. Haematologica. 2013;98(10):1554-1562.
Yamazaki T, Ohno H. Double-hit lymphoma with t(8;14)(q24;q32) and t(12;14)(q24;q32) chromosomal translocations. Intern Med. 2011;50(21):2659-2662.

Close metadata