BACKGROUNDOver the past 20 years,we have gained a deep understanding of the biologicalheterogeneity of diffuse large B cell lymphoma(DLBCL)and have developed arange of new treatment programs based on the characteristi...BACKGROUNDOver the past 20 years,we have gained a deep understanding of the biologicalheterogeneity of diffuse large B cell lymphoma(DLBCL)and have developed arange of new treatment programs based on the characteristics of the disease,bringing us to the era of immune-chemotherapy.However,the effectiveness andmolecular mechanisms of targeted-immunotherapy remain unclear in DLBCL.Targeted-immunotherapy may be beneficial for specific subgroups of patients,thus requiring biomarker assessment.CASE SUMMARYHere,we report a case of MCD subtype DLBCL with MYD88L265P and CD79Bmutations,considered in the initial stage as lymphoplasmic lymphoma(LPL)orWaldenstrom macroglobulinemia(WM).Flow cytometry supported this view;however,the immunohistochemical results of the lymph nodes overturned theabove diagnosis,and the patient was eventually diagnosed with MCD subtypeDLBCL.The presence of a monoclonal IgM component in the serum and infiltrationof small lymphocytes with a phenotype compatible with WM into the bonemarrow led us to propose a hypothesis that the case we report may have transformedfrom LPL/WM.CONCLUSIONThis highlights the possible transformation from WM to DLBCL,CD79B mutationmay be a potential biomarker for predicting this conversion.展开更多
<strong>Objective:</strong> To detect the positive rate of MyD88 l265p mutation in DLBCL patients, and analyze the correlation between MYD88 L265p mutation and DLBCL prognosis. <strong>Methods:</s...<strong>Objective:</strong> To detect the positive rate of MyD88 l265p mutation in DLBCL patients, and analyze the correlation between MYD88 L265p mutation and DLBCL prognosis. <strong>Methods:</strong> In this study, 40 formalin fixed paraffin embedded tissue samples were collected from the pathology department of the Fourth Affiliated Hospital and the First Affiliated Hospital of Anhui Medical University from January 2017 to December 2019. The relationship between MYD88 L265p gene mutation and clinicopathological parameters of DLBCL, such as age, gender, Ann Arbor stage, site, B symptom, NCCN-IPI and IPI score, ECOG PS score, serum ferritin, <em>β</em>2-microglobulin and LDH levels were analyzed. <strong>Results:</strong> The positive rate of MYD88 L265p was 20% (8/40), 25.0% (6/24) in non GCB and 12.5% (2/16) in GCB. There were no significant differences in age, gender, location, extranodal invasion site, <em>β</em>2-microglobulin, serum ferritin and LDH between wild-type and mutant type of MYD88 gene, but had statistical significance with Han’s classification. MYD88 L265p gene mutation was associated with Ann Arbor stage, NCCN-IPI score and IPI score. <strong>Conclusion:</strong> MYD88 L265P mutation is closely related to the occurrence, development and prognosis of DLBCL. It is an adverse prognostic factor of DLBCL and may be used for the prognosis evaluation of DLBCL.展开更多
文摘BACKGROUNDOver the past 20 years,we have gained a deep understanding of the biologicalheterogeneity of diffuse large B cell lymphoma(DLBCL)and have developed arange of new treatment programs based on the characteristics of the disease,bringing us to the era of immune-chemotherapy.However,the effectiveness andmolecular mechanisms of targeted-immunotherapy remain unclear in DLBCL.Targeted-immunotherapy may be beneficial for specific subgroups of patients,thus requiring biomarker assessment.CASE SUMMARYHere,we report a case of MCD subtype DLBCL with MYD88L265P and CD79Bmutations,considered in the initial stage as lymphoplasmic lymphoma(LPL)orWaldenstrom macroglobulinemia(WM).Flow cytometry supported this view;however,the immunohistochemical results of the lymph nodes overturned theabove diagnosis,and the patient was eventually diagnosed with MCD subtypeDLBCL.The presence of a monoclonal IgM component in the serum and infiltrationof small lymphocytes with a phenotype compatible with WM into the bonemarrow led us to propose a hypothesis that the case we report may have transformedfrom LPL/WM.CONCLUSIONThis highlights the possible transformation from WM to DLBCL,CD79B mutationmay be a potential biomarker for predicting this conversion.
文摘<strong>Objective:</strong> To detect the positive rate of MyD88 l265p mutation in DLBCL patients, and analyze the correlation between MYD88 L265p mutation and DLBCL prognosis. <strong>Methods:</strong> In this study, 40 formalin fixed paraffin embedded tissue samples were collected from the pathology department of the Fourth Affiliated Hospital and the First Affiliated Hospital of Anhui Medical University from January 2017 to December 2019. The relationship between MYD88 L265p gene mutation and clinicopathological parameters of DLBCL, such as age, gender, Ann Arbor stage, site, B symptom, NCCN-IPI and IPI score, ECOG PS score, serum ferritin, <em>β</em>2-microglobulin and LDH levels were analyzed. <strong>Results:</strong> The positive rate of MYD88 L265p was 20% (8/40), 25.0% (6/24) in non GCB and 12.5% (2/16) in GCB. There were no significant differences in age, gender, location, extranodal invasion site, <em>β</em>2-microglobulin, serum ferritin and LDH between wild-type and mutant type of MYD88 gene, but had statistical significance with Han’s classification. MYD88 L265p gene mutation was associated with Ann Arbor stage, NCCN-IPI score and IPI score. <strong>Conclusion:</strong> MYD88 L265P mutation is closely related to the occurrence, development and prognosis of DLBCL. It is an adverse prognostic factor of DLBCL and may be used for the prognosis evaluation of DLBCL.
