20.500.12556/RUL-164911 Do double-expressor high-grade B-cell lymphomas really need intensified treatment? a report from the real-life series of high-grade B-cell lymphomas treated with different therapeutic protocols at the Institute of Oncology Ljubljana High-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 rearrangements are known for their aggressive clinical course and so are the ones with MYC and BCL2 protein overexpression. The optimal therapy for these lymphomas remains to be elucidated. A retrospective analysis of all diffuse large B-cell lymphomas and high-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 rearrangements diagnosed between 2017 and 2021 at the Institute of Oncology Ljubljana, Slovenia, has been performed. Only patients with double-expressor lymphoma (DEL), double-hit lymphoma (DHL), or triple-hit lymphoma (THL) were included. Demographic and clinical parameters were assessed, as well as progression-free survival (PFS) and overall survival (OS). In total, 161 cases out of 309 (161/309; 52,1%) were classified as DEL. Sixteen patients had DHL, MYC/BCL2 rearrangement was observed in eleven patients, and MYC/BCL6 rearrangement was observed in five patients. Five patients were diagnosed with THL. Out of 154 patients (according to inclusion/exclusion criteria) included in further evaluation, one-hundred and thirty-five patients had double-expressor lymphoma (DEL), sixteen patients had DHL, and three patients had THL. In total, 169 patients were treated with R-CHOP, 10 with R-CHOP and intermediate-dose methotrexate, 19 with R-DA-EPOCH, and 16 with other regimens. The median follow-up was 22 months. The 5-year OS for the whole DEL group was 57.1% (95% CI 45.9–68.3%) and the 5-year PFS was 76.5% (95% CI 72.6–80.4%). The log-rank test disclosed no differences in survival between treatment groups (p = 0.712) while the high-risk international prognostic index (IPI) carried a significantly higher risk of death (HR 7.68, 95% CI 2.32–25.49, p = 0.001). The 5-year OS for DHL patients was 32.4% (95% CI 16.6–48.2%) while all three TH patients were deceased or lost to follow-up. Our analyses of real-life data disclose that the R-CHOP protocol with CNS prophylaxis is a successful and curative treatment for a substantial proportion of DEL patients. lymphoma double-expressor lymphoma oncology double-hit lymphoma R-CHOP R-DA-EPOCH IPI score limfomi dvojno izražen limfom onkologija true false true Angleški jezik Slovenski jezik Članek v reviji 2024-11-15 13:32:21 2024-11-15 13:32:27 2024-11-22 14:56:38 0000-00-00 00:00:00 2024 0 0 13 str. iss. 2, art. 275 Vol. 12 2024 0000-00-00 Zaloznikova Objavljeno apc 0000-00-00 0000-00-00 0000-00-00 616.4 2227-9059 10.3390/biomedicines12020275 183791619 biomedicines-12-00275.pdf biomedicines-12-00275.pdf 1 8A7447FCB556F26857FD76444EC0AAA1 92ab9c5134df2886050af71ce78700316e3d5a4055769024ce7ceda800a735f8 86bae2b0-a34d-11ef-b232-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=195761 https://www.mdpi.com/2227-9059/12/2/275 1 4ebc3a65-a34d-11ef-b232-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=195760 Medicinska fakulteta 0 0 0