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MYD88 mutational status improves classification and prognostication in DLBCL
(HR 1.42, 95%-CI 0.85-2.37), whilst ECOG-PS, Ann Arbor stage, and extranodal location were prognostic in this model.
Further multivariable analyses were performed to eval- uate the prognostic significance of MYD88 mutational sta- tus in comparison to the COO subtype or anatomical lym- phoma location. The COO subtype did not improve the performance of models 2 and 3 (results not shown). However, the prognostic impact of model 2 was improved by adding the anatomical lymphoma location (CVC index
= 0.71, model 4, presented in the Online Supplementary Table S1) and outperforms model 2 (Table 3A, CVC index = 0.69, including the IPI factors and molecular aberrations of WHO 2016). Model 4 demonstrated a nearly identical prognostic performance when compared to model 3 (CVC index = 0.70, including the IPI factors, molecular aberra- tions of WHO 2016 and the mutational status of MYD88 and CD79B). When adding the mutational status of MYD88 and CD79B to model 4, the performance of this model 5 was not improved (CVC index 0.71, Online
ABC
D
EF
GH
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Figure 3. Prognostic significance of anatomical location, IPI Score and MYD88 in DLBCL. OS, PFS, and cumulative incidence of relapse/progression compared to NRM (1st row: Location, 2nd row: IPI Score, 3rd row: MYD88). CRS: competing risk; OS: overall survival; PFS: progression free survival; NRM: non-relapsed mortality.
Table 4. Mutated MYD88 improved the prognostic performance of the IPI.
Overall survival
Univariable Multivariable
HR 95%-CI HR 95%-CI
1.73 1.45-2.08 1.77 1.47-2.13
1.83 1.19-2.80
0.57 0.61
Cause-specific hazard (CSH) for relapse/progression
Univariable
Multivariable
IPI-score
As continuous variable
MYD88
Mutated (vs. Wildtype) Cross-validated C-index
HR
1.45
95%-CI
1.21-1.73
HR
1.47
1.69
95%-CI
1.22-1.76
1.09-2.60
0.53
0.57
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