MYC重排对于B细胞淋巴瘤、不可归类性、介于弥漫性大B细胞...

gardeniay

MYC重排对于B细胞淋巴瘤、不可归类性、介于弥漫性大B细胞淋巴瘤和伯基特淋巴瘤之间者的预后价值
Prognostic Value of MYC Rearrangement in Cases of B-cell Lymphoma, Unclassifiable, With Features Intermediate Between Diffuse Large B-Cell Lymphoma and Burkitt Lymphoma

Background:

B-cell lymphoma, Unclassifiable with features intermediate between diffuse large B-cell lymphoma (DLBCL) and Burkitt lymphoma, for convenience referred to here as unclassifiable B-cell lymphoma, is a category in the 2008 World Health Organization system used for a group of histologically aggressive neoplasms that are difficult to classify definitively. Currently, there is no established standard therapy for these neoplasms.

Methods:

The authors assessed MYC status and correlated it with treatment response and outcome in a group of 52 patients with unclassifiable B-cell lymphoma treated with either a standard DLBCL regimen (R-CHOP [rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone-related therapy]) or more intensive regimens, such as R-hyper-CVAD (rituximab plus hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternating with high-dose methotrexate and cytarabine). The regimens were selected by the treating clinicians based on the overall clinical and pathological findings.

Results:

Thirty (58%) unclassifiable B-cell lymphomas had MYC abnormalities (MYC+) including 27 with rearrangement, 2 with amplification, and 1 with both. The MYC+ and MYC? groups were similar in their age distribution and International Prognostic Index scores. Progression-free survival of patients with MYC+ unclassifiable B-cell lymphoma treated initially with R-CHOP was significantly worse than patients treated with R-hyper-CVAD (P=.0358). In contrast, for the MYC? unclassifiable B-cell lymphoma group, some patients responded to R-CHOP, and others were refractory to R-hyper-CVAD.

Conclusions:

MYC aberrations are common in unclassifiable B-cell lymphoma. The presence of MYC aberrations identifies a patient subset that requires more aggressive therapy than R-CHOP. In contrast, MYC unclassifiable B-cell lymphoma patients responded variably to either R-CHOP or aggressive therapy, and the latter showed no survival advantage.

有次和范医生咨询病情的时候，范医生建议我们做个myc重排，于是在网上搜到了这么篇摘要（里面的全文我看不到）。
最后的结论是myc重排阳性的需要用比r-chop更强一些的方案，而myc重排阴性的患者使用更强方案，并没有多大优势。

结外惰性淋巴瘤

gardeniay 发表于 2013-8-2 22:45
MYC重排对于B细胞淋巴瘤、不可归类性、介于弥漫性大B细胞淋巴瘤和伯基特淋巴瘤之间者的预后价值
Prognostic ...

您好，我的免疫组化显示myc阳性，可是fish又是阴性'。该怎么办