Format

Send to

Choose Destination
Biol Blood Marrow Transplant. 2017 Dec;23(12):2199-2204. doi: 10.1016/j.bbmt.2017.08.022. Epub 2017 Aug 26.

Lack of a Prognostic Impact of the MyD88 L265P Mutation for Diffuse Large B Cell Lymphoma Patients Undergoing Autologous Stem Cell Transplantation.

Author information

1
Section of Hematopathology, Department of Immunology and Pathology, Washington University School of Medicine, St. Louis, Missouri.
2
Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
3
Abbott Molecular, Inc., Des Plaines, Illinois.
4
Department of Internal Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, Missouri.
5
Department of Internal Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, Missouri. Electronic address: kian-huat.lim@wustl.edu.

Abstract

Cell-of-origin determination has emerged as an important prognostic factor for patients initially diagnosed with diffuse large B cell lymphoma (DLBCL). Specifically, the nongerminal center B cell-like (non-GCB) subtype, composed predominantly of the activated B cell-like (ABC) molecular subtype, has been shown to portend poor prognosis because of its more aggressive nature and resistance to standard cyclophosphamide, hydroxydaunorubicin, oncovin, prednisone (CHOP)-like chemotherapy compared with the GCB subtype. The recurrent MyD88 L265P mutation, present in 29% of ABC DLBCL, was reported as an independent poor prognostic factor for patients with newly diagnosed DLBCL. For patients whose disease relapses or is refractory to first-line chemotherapy, high-dose chemotherapy with autologous stem cell transplantation (ASCT) is frequently offered as salvage therapy. However, the impact of MyD88 mutation status on post-ASCT outcome has not been reported. Here, we retrospectively analyzed, with up to 20 years of follow-up, 165 patients who underwent ASCT for relapsed/refractory DLBCL at our institution. We found that MyD88 mutation status did not correlate with overall survival (OS), post-ASCT OS, or progression-free survival (PFS). Patients with non-GCB subtype had significantly worse OS from initial diagnosis and after ASCT. Notably, high International Prognostic Index score was predictive of poor pre- and post-transplant PFS and post-transplant OS.

KEYWORDS:

Autologous stem cell transplant; Cell of origin; DLBCL; MyD88; Prognosis

PMID:
28847710
DOI:
10.1016/j.bbmt.2017.08.022
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center