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MYD88 mutational status improves classification and prognostication in DLBCL
cal analyses. With this definition, 83 patients (33.5%) were categorized as having regional disease (Ann Arbor stage I-II) and 165 patients (66.5%) had advanced disease (stage III-IV). Sixty-one patients (25.3%) had an IPI risk score of 0/1, 148 patients (61.4%) an IPI of 2-3, and 32 patients (13.3%) an IPI of 4-5. The IPI of nine patients was
unknown. The majority of (extra)nodal and testicular DLBCL patients were treated with R-CHOP (N=160), CHOP (N=25), or (R)CHOP-like treatments (N=5) with curative intent. Curative treatment regimens incorporat- ing high-dose methotrexate were initiated for 23 patients with PCNSL. Because of older age, poor clinical Eastern
Figure 1. Oncoprint plot of the molecular analysis of 250 cases with diffuse large B-cell lymphoma (DLBCL). EBV: Epstein-Barr virus; GCB: germinal center B-cell; IP: immune-privileged. Of 52 cases, molecular analysis was not complete due to results that were ambiguous to interpret or no FFPE material was left for subsequent analysis.
Table 2. Hans’ algorithm and molecular analysis at time of diagnosis.
All patients (N=250)
Cell-of-origin, according to Hans’ algorithm (N=250)
Nodal (N=75)
36 (48.0 %) 35 (46.7 %) 4 (5.3 %)
62 (82.7 %)
13 (17.3 %)
70 (95.9 %) 3 (4.1 %)
59 (85.5 %)
10 (14.5 %)
53 (74.6 %) 18 (25.4 %)
57 (82.6 %)
12 (17.4 %)
66 (95.7 %) 3 (4.3 %)
65 (89.0 %)
8 (11.0 %) 21 (31.8 %)
45 (68.2 %)
Extranodal with/without nodal (N=108)
38 (58.3 %) 63 (35.2 %) 7 (6.5 %)
92 (85.2 %)
16 (14.8 %)
88 (90.7 %) 9 (9.3 %)
89 (90.8 %)
9 (9.2 %)
89 (89.9 %) 10 (10.1 %)
78 (79.6 %)
20 (20.4 %)
98 (97.0 %) 3 (3.0 %)
88 (83.8 %)
17 (16.2 %) 27 (32.1 %)
57 (67.9 %)
Immune-privileged (N=67)
26 (38.8%) 32 (47.8 %) 9 (13.4 %)
22 (32.8 %)
45 (67.2 %)
49 (74.2 %) 17 (25.8 %)
46 (92.0 %)
4 (8.0 %)
49 (96.1 %) 2 (3.9 %)
38 (76.0 %)
12 (24.0 %)
48 (94.1 %) 3 (5.9 %)
58 (95.1 %)
3 (4.9 %) 3 (6.3 %)
45 (93.8 %)
P*
0.228
<0.001
<0.001
0.434
0.001
0.675
0.686
0.091
0.002
GCB Non-GCB Unclassifiable
MYD88 (N=250) Wildtype Mutated
CD79B (N=236) Wildtype Mutated
MYC (N=217) Wildtype Rearranged
BCL2 (N=221) Wildtype Rearranged
BCL6 (N=217) Wildtype Rearranged
High grade B-cell lymphoma (N=221) Negative
Positive
EBV status (N=239)
Negative
Positive
Genetic aberrations (N=198)
None
One or more
100 (40.0 %) 130 (52.0 %) 20 (8.0 %)
176 (70.4 %)
74 (29.6 %)
207 (87.7 %) 29 (12.3 %)
194 (89.4 %)
23 (10.6 %)
191 (86.4 %) 30 (13.6 %)
173 (79.7 %)
44 (20.3 %)
212 (95.9 %) 9 (4.1 %)
211 (88.3 %)
28 (11.7 %) 51 (25.8 %)
147 (74.2 %)
EBV: Epstein-Barr virus.*P-value indicating a difference in distribution between the three subgroups as calculated by Pearson’s χ2 test.The number between brackets in the left- hand column represents the number of patients from whom this information was available.
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