ABSTRACT
High Grade B Cell Lymphoma, NOS, and High Grade B Cell Lymphoma with Dual Hit or Triple Hit have been recently recategorized in the 2016 revision of the WHO classification of lymphoid neoplasms. In this study we have characterized the genetic, histopathological, and clinical features of a series of this type of lymphoid neoplasia (17 HGBCL NOS and 53 HGBCL DH/TH).HGBCL NOS showed better response to first line treatment than HGBCL with DH/TH but no significant differences in PFS or OS were found between the two categories. Survival analysis in the whole cohort of cases found that only the presence of BCL2 translocation was significantly associated with PFS. Other clinical features such as IPI, LDH or stage were equivalent in both categories. Furthermore, both high grade and DLBCL morphological patterns showed equivalent PFS and OS in this set of High grade BCL NOS/DH/TH.Key pointsBCL2 translocation in High Grade B Cell Lymphoma NOS and High Grade B Cell Lymphoma with DH/TH is associated with reduced progression free survival.Both high grade and DLBCL morphological patterns showed equivalent outcome regarding PFS and OS in HGBCL.
Subject(s)
Lymphoma, Large B-Cell, Diffuse , Cohort Studies , Humans , Lymphoma, Large B-Cell, Diffuse/drug therapy , Progression-Free Survival , Proto-Oncogene Proteins c-bcl-2/genetics , Proto-Oncogene Proteins c-myc/genetics , Translocation, GeneticABSTRACT
BACKGROUND: We herein report the long-term results of an allogeneic reduced-intensity conditioning (allo-RIC) protocol used in 21 consecutive patients (16 males, median age 56 years, 71% in complete remission) diagnosed with mantle cell lymphoma (MCL). METHODS: The allo-RIC consisted of fludarabine plus melphalan and peripheral blood hematopoietic stem cells (PBSCs) from human leukocyte antigen (HLA)-identical siblings were used in all cases. Median CD34+ infused cells was 5.8 times 10(6)/kg. All patients engrafted promptly. RESULTS: Early toxicity included mild/moderate mucositis (43%), febrile neutropenia (33%) and bacterial infections (19%). With a median follow up of 48 months, four deaths were reported, all due to infections and/or graft-versus-host disease (GVHD), yielding a 3-year cumulative incidence of nonrelapse mortality of 19.5%. Grade III-IV acute GVHD occurred in 15% and chronic GVHD in 78%, being extensive in 39%. The 5-year progression-free survival (PFS) and overall survival (OS) were both 80% (95% CI: 63-97%). Age was the only possible prognostic factor for OS, which was 43% for those aged more than 60 years and 100% for those younger (p < 0.001). CONCLUSIONS: Our data confirm that allo-RIC offers a low toxicity profile and a chance for prolonged long-term disease-free survival in MCL, particularly in younger patients.
