Highlights
- •Diffuse large B-cell lymphoma patients with MYC gene rearrangements have a dismal outcome on rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) therapy.
- •Dismal outcome on standard therapy with R-CHOP justifies new treatment modalities
- •Intensification of classical chemotherapy is not leading to better overall survival
- •New therapies will be more specifically targeted against MYC and MYC related proteins
Abstract
In the past decade, patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL)
were treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and
prednisone) therapy. Standard treatment is now changing as a result of deeper understanding
of underlying biologic differences of such lymphomas. One of the most powerful predictors
of an adverse outcome on R-CHOP therapy is the presence of a MYC gene rearrangement (MYC+ lymphoma). Determination of MYC gene rearrangement by FISH (fluorescent in situ hybridisation) has recently become a standard diagnostic procedure.
In this paper, an overview of current literature on MYC function and MYC+ lymphoma patient outcome is presented. Furthermore, we present 26 patients from
our tertiary referral centre who were diagnosed with MYC+ lymphoma between 2009 and 2014. In our patient series, we confirm the dismal prognosis
of MYC+ lymphoma patients. Intensification of classical chemotherapy does not lead to better
overall survival, justifying new treatment modalities. First line therapy should be
more specifically targeted against MYC and the genes and proteins that are deregulated
by MYC. To this end, the first clinical trial in which MYC+ patients will be offered targeted treatment has recently been launched.
Keywords
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Article info
Publication history
Published online: January 25, 2016
Accepted:
December 4,
2015
Received in revised form:
October 22,
2015
Received:
May 10,
2015
Identification
Copyright
© 2015 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
