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Master Thesis

Adverse outcome in follicular lymphoma are associated with MYC rearrangements but not MYC extra-copies

Abstract : CONTEXT: Follicular lymphoma (FL) with MYC-Rearrangements (MYC-R) and MYC-Extra Copies (MYC-EC) are rare and their prognosis impact are uncertain. OBJECTIVE: We investigated MYC alterations in de novo FL and their clinical impact on patients treated with immuno-chemotherapy. Secondly, we addressed the question of the impact of MYC-EC in a subgroup of patients from the PRIMA trial in order to validate our results in an independent cohort. MATERIEL AND METHODS: We conducted a retrospective multicentric study including patients with diagnosis of de novo FL with available conventional cytogenetic data from January 2001 and January 2020. We reviewed all cases to compare the outcome according to the presence of MYC alterations. RESULTS: We included 321 FL, 259 (81%) patients had no 8q24 alterations and 62 (19%) were assigned to 8qAlt. Forty-five cases were classified as MYC-EC and 6 as MYC-R. MYC-R patients were significantly older (p=0.008), had higher FLIPI stage (p=0.05) and β2m (p=0.05). Considering patients treated with immuno-chemotherapy, 4 presented a MYC-R and 25 a MYC-EC. Univariate analysis showed the absence of significant difference between MYC-EC and MYC-NL regarding PFS (HR : 1.3 ; 95% CI [0.4-1.6]) and SOS (HR : 1,6 ; 95% CI [0,4-5,7]). Those results were confronted to data from the PRIMA trial. It confirmed that MYC-EC had no impact on PFS (p=0.86) or SOS (p=0.9). Conversely, MYC-R was associated with a trend to poorer outcome regarding PFS (HR : 6.1 ; 95% CI [2.2-17.1] ; p=0.00026), death from lymphoma (SOS HR : 13.6 ; 95% CI [2,9-65] ; p=0.00014) and risk of transformation (TFS HR : 82.7 ; 95% CI [14.8-463.4] ; p<0.0001). CONCLUSION: In conclusion, MYC-EC has no prognosis impact in FL but MYC-R FL tended to be associated with an increased risk of transformation and poorer outcome.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03253187
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Submitted on : Wednesday, June 30, 2021 - 2:09:03 PM
Last modification on : Friday, July 2, 2021 - 3:27:58 AM

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  • HAL Id : dumas-03253187, version 1

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Lucile Emilie Anne Bussot. Adverse outcome in follicular lymphoma are associated with MYC rearrangements but not MYC extra-copies. Human health and pathology. 2021. ⟨dumas-03253187⟩

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