Development of a Prognostic Scoring System using MYC Expression and Soluble Interleukin Receptor -2 level for Diffuse Large B-cell Lymphoma

• Published in: YONAGO ACTA MEDICA Vol. 66; no. 1; pp. 56 - 66
• Main Authors: Suzuki, Sayaka, Kuwamoto, Satoshi, Kawamura, Koji, Matsushita, Michiko, Motokura, Toru, Hosoda, Yuzuru, Maegaki, Masaya, Hosoda, Rina, Hara, Kentaro, Umekita, Yoshihisa, Fukuda, Tetsuya
• Format: Journal Article
• Language: English
• Published: Japan Tottori University Medical Press 2023; YAM
• Subjects: Original; R-CHOP chemotherapy; MYC; not otherwise specified; Proto-Oncogene Proteins; non-Hodgkin lymphoma; diffuse large B-cell lymphoma; immunohistochemistry
• ISSN: 0513-5710; 1346-8049
• DOI: 10.33160/yam.2023.02.007

[ABSTRACT] [Background] Diffuse large B-cell lymphoma, not otherwise specified (DLBCL-NOS), is the most frequent type of lymphoid neoplasm. [Methods] We investigated the relationships between clinical factors of DLBCL-NOS and MYC immunohistochemistry (IHC) staining. [Results] A total of 110 patients diagnosed with DLBCL-NOS from 2012 to 2020 at Tottori University Hospital and treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) chemotherapy were included. IHC staining of MYC in formalin-fixed, paraffin-embedded tumor specimens was performed, and ROC-curve analysis revealed the cut-off value of the MYC positive rate as 55%. The 2-year overall survival (OS) rates of the MYC-negative and -positive groups were 84.7% vs 57.7% (P = 0.0091), and the progression-free survival rates were 77.8% vs 54.7% (P = 0.016), respectively. Multivariate analysis for OS showed prognostic significance of MYC positivity [hazards ratio (HR): 2.496; P = 0.032], and serum levels of soluble interleukin-2 receptor (sIL-2R) > 2000 U/mL (HR: 3.950; P = 0.0019), as well as age > 75 (HR: 2.356; P = 0.068). The original scoring system was developed based on these findings. By assigning one point to each item, age (> 75), MYC positivity, and sIL-2R level (> 2000), all patients were classified into three risk categories: group 1 (0 points), group 2 (1 point), and group 3 (2-3 points). The 2-year survival rates were 100%, 83.0%, and 47.1% for the groups 1, 2, and 3, respectively (P < 0.0001). [Conclusion] We suggest that a prognostic scoring system using MYC expression and soluble interleukin receptor -2 level is useful for the prediction of prognosis, contributing to further stratification in DLBCL-NOS.