临床、实验室和淋巴结 MYD88 L265P 突变在弥漫性大 B 细胞淋巴瘤患者风险评估中的作用。

Utility of clinical, laboratory, and lymph node MYD88 L265P mutation in risk assessment of diffuse large B-cell lymphoma patients.

机构信息

Clinical Hematology, Internal Medicine Department, Oncology Center, Mansoura University, PO Box 35516, Mansoura, Egypt.

Pathology Department, Faculty of Medicine, Mansoura University, PO Box 35516, Mansoura, Egypt.

出版信息

J Egypt Natl Canc Inst. 2024 Oct 14;36(1):31. doi: 10.1186/s43046-024-00237-z.

DOI:10.1186/s43046-024-00237-z

PMID:39397180

Abstract

BACKGROUND

Diffuse large B-cell lymphoma (DLBCL) is an aggressive non-Hodgkin lymphoma and is characterized by heterogeneity in biology and clinical behavior. Mutations in the myeloid differentiation primary response 88 (MYD88) are found in different lymphoproliferative disorders and are associated with variable clinical and prognostic impact.

AIM

To investigate the frequency of MYD88 L265P mutation and its clinical impact in a cohort of Egyptian DLBCL patients.

METHODS

FFPE lymph node samples from 87 DLBCL patients (46 males / 41 females; median age, 58 years) were included and analyzed for MYD88 L265P by an allele-specific PCR.

RESULTS

MYD88 L265P mutations were found in 52 patients (59.8%) out of 87 DLBCL cases. Patients with L265 mutation were significantly younger than non-mutated patients (p = 0.022). None of the patients with the L265P mutation showed a significant association with the clinical parameters of DLBCL. Interestingly, MYD88 L265 mutated patients were found to be significantly correlated with HCV infection (p = 0.037). The median follow-up time across the entire cohort was 26 months. Univariate analysis showed that overall survival (OS) was affected by gender, LDH level, and CNS-IPI scoring (p = 0.048, 0.008, and 0.046, respectively), while disease-free survival (DFS) was affected by B symptoms and LDH level (p = < 0.000 and 0.02, respectively). However, the MYD88 mutation status and other prognostic factors showed no association with OS or DFS.

CONCLUSIONS

Our findings indicate a high frequency of MYD88 L265P mutations in our study population and not associated with prognostic markers or the outcome of the disease.

摘要

背景

弥漫性大 B 细胞淋巴瘤（DLBCL）是一种侵袭性非霍奇金淋巴瘤，其生物学和临床行为具有异质性。髓样分化初级反应 88（MYD88）突变存在于不同的淋巴增生性疾病中，并与可变的临床和预后影响相关。

目的

研究 MYD88 L265P 突变在埃及 DLBCL 患者中的频率及其临床意义。

方法

纳入 87 例 DLBCL 患者（46 例男性/41 例女性；中位年龄 58 岁）的 FFPE 淋巴结样本，通过等位基因特异性 PCR 分析 MYD88 L265P。

结果

87 例 DLBCL 病例中，52 例（59.8%）发现 MYD88 L265P 突变。突变患者明显比非突变患者年轻（p=0.022）。L265 突变的患者与 DLBCL 的临床参数均无显著相关性。有趣的是，MYD88 L265 突变患者与 HCV 感染显著相关（p=0.037）。整个队列的中位随访时间为 26 个月。单因素分析显示，总生存（OS）受性别、LDH 水平和 CNS-IPI 评分的影响（p=0.048、0.008 和 0.046），而无病生存（DFS）受 B 症状和 LDH 水平的影响（p=0.000 和 0.02）。然而，MYD88 突变状态和其他预后因素与 OS 或 DFS 无关联。