Advanced patient age at diagnosis of diffuse large B-cell lymphoma is associated with molecular characteristics including ABC-subtype and high expression of MYC

Abstract

The incidence of diffuse large B-cell lymphoma (DLBCL) increases with age being patient age at diagnosis an adverse prognostic factor. However, elderly patients are often underrepresented in common studies. To investigate the effect between age and biological characteristics in DLBCL, we analyzed data of 1534 patients encompassing all adult age groups, enriched for the age ≥75 years. Follicular lymphoma (FL) grade 3B with histopathological characteristics of DLBCLs were included. Gender, centroblastic cytology, FL grade 3B morphology, CD10 expression, and ABC/non-GCB-subtype were significantly associated with age after correction for multiple testing and after adjusting for cohorts. Analysis of a subgroup points towards an association of MYC expression with age. Our data indicate that biological features of DLBCL and FL grade 3B are associated with increasing age among adult patients. The prevalence of the ABC/non-GCB-subtype in elderly patients suggests that therapies targeting this molecular subtype should be specifically explored in this subgroup.

Keywords:

• Adult patients
• diffuse large B-cell lymphoma
• molecular features

Acknowledgments

The authors are grateful to Eva Maria Murga Penas for her excellent comments and for editing the manuscript. We would like to thank Charlotte Botz-von-Drathen, Reina Zühlke-Jenisch, and Claudia Becher for their excellent technical assistance and the MMML project, the NHL-B and the RICOVER clinical trial groups for providing data. The authors thank Professor Alexander Katalinic for kindly providing data of Krebsregister Schleswig-Holstein. This study is supported by the Dr. Werner Jackstädt Foundation in the framework of a Junior Excellence Research Group on ‘Mechanisms of B-cell lymphomagenesis in the Senium as basic principle for the development of age adjusted therapy regimes’ (S134 - 10.100). Funding by the German Ministry for Education and Science (BMBF) through contracts 0316166I and 031A428H is gratefully acknowledged. Furthermore, Infrastructure provided by the KinderKrebsInitiative Buchholz/Holm-Seppensen and previous grant support for the MMML project by the Deutsche Krebshilfe (2003–2011) are gratefully acknowledged.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at https://doi.org/10.1080/10428194.2017.1365851.

Additional information

Funding

Bundesministerium für Bildung und Forschung, [10.13039/501100002347] and [0316166I, 031A428H]. This work was supported by the Dr. Werner Jackstädt Foundation, [S134 - 10.100].