Combination of BCL-2 and MYC protein expression improves high-risk stratification in diffuse large B-cell lymphoma

Figures & data

Table 1 Patient characteristics

Patient characteristics	Value
Number	20
Median age, years (range)	59 (30–75)
Male sex (%)	50
IPI factors
Age greater than 60 years (%)	65
ECOG greater than 2 (%)	30
Elevated LDH (%)	75
More than 1 extranodal site (%)	75
Stage III/IV (%)	75
Tumor characteristics
MYC overexpression (%)	65
BCL-2 overexpression (%)	90
MYC and BCL-2 overexpression (%)	60

Abbreviations: IPI, International Prognostic Index; ECOG, Eastern Cooperative Oncology Group.

Figure 1 Survival according to the NCCN-IPI.

Notes: (A) Progression-free survival. (B) Overall survival.
Abbreviations: OS, overall survival; PFS, progression-free survival; IPI, International Prognostic Index; NCCN, National Comprehensive Cancer Network.

Figure 2 Survival according to the IPI.

Notes: (A) Progression-free survival. (B) Overall survival.
Abbreviations: OS, overall survival; PFS, progression-free survival; IPI, International Prognostic Index; NCCN, National Comprehensive Cancer Network.

Table 2 Risk stratification and outcomes of 4-year OS and PFS

Risk group	Number of prognostic factors	Patients	4-yr PFS (%)	4-yr OS (%)
IPI
Low	0, 1	0	–	–
Low-intermediate	2	0	–	–
High-intermediate	3	11/20	0	23.9
High	4, 5	9/20	27.8	55.6
NCCN-IPI
Low	0, 1	0	–	–
Low-intermediate	2, 3	4/20	0	0
High-intermediate	4, 5	12/20	25.0	50.0
High	6, 7, 8	4/20	0	50.0
Revised IPI
Low	0	0	–	–
Intermediate	1, 2	0	–	–
High	3, 4, 5	20/20	16.9	33.3

Abbreviations: OS, overall survival; PFS, progression-free survival; IPI, International Prognostic Index; NCCN, National Comprehensive Cancer Network.

Table 3 Four high-risk patients’ characteristics

	Patient number 1	Patient number 2	Patient number 3	Patient number 4
Age (years)	50	30	51	53
Sex	Male	Male	Male	Male
ECOG	1	1	1	1
LDH (220 U/L)	493	404	350	107
Extranodal site of disease	–	Bone marrow	–	Bone marrow
Stage	III	IV	III	IV
MYC expression (%)	95	65	85	60
BCL-2 expression (%)	85	85	75	50
Replase (months)	6	12	10	15
Survival (months)	45	13	10	16
NCCN-IPI score	3	3	3	3

Abbreviations: IPI, International Prognostic Index; ECOG, Eastern Cooperative Oncology Group; LDH, lactate dehydrogenase; NCCN, National Comprehensive Cancer Network.

Figure S1 (A) MYC protein expression was exclusively brown nuclear (×400). (B) BCL-2 protein expression was exclusively brown cytoplasm (×400).