TY - JOUR T1 - Role of MYC and BCL2 expression in a cohort of 43 patients with DLBCL: a retrospective study JF - Journal of Clinical Pathology JO - J Clin Pathol DO - 10.1136/jclinpath-2020-207121 SP - jclinpath-2020-207121 AU - Umair Tahir Khan AU - Michael Kelly AU - James Dodd AU - Sammy Fergiani AU - Barbara Hammer AU - Jeffrey Smith AU - Arvind Arumainathan AU - Mark Atherton AU - Anthony Carter AU - Igor Racu-Amoasii AU - Nagesh Kalakonda AU - Andrew Pettitt AU - Geetha Menon Y1 - 2020/12/30 UR - http://jcp.bmj.com/content/early/2021/09/27/jclinpath-2020-207121.abstract N2 - Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of high-grade non-Hodgkin’s lymphoma, representing a group of heterogeneous diseases with varied responses and prognosis. Although prognostication tools exist such as the International Prognostic Index (IPI), they do not account for underlying tumour biology and therefore marked differences exist in outcomes within each group. With the advent of genetic profiling, new subtypes have been recognised; however, their application to the clinical setting has been limited due to cost of equipment and lack of expertise.To improve prognostication and account for variable response in DLBCL, the role of MYC and BCL2 oncogenes has been implicated in the pathogenesis of DLBCL1–5 using immunohistochemistry (IHC). Double-expresser lymphoma indicates all patients in which upregulation of these proteins is evidenced using IHC, typically at ≥40% for MYC and >50%–70% for BCL2. There remains controversy about first, whether coexpression of MYC and BCL2 independent of their translocation status can predict prognosis1 6–8 and second, what cut-offs are clinically significant for MYC and BCL2 expression.1 6 8 We have therefore investigated these in our cohort of 43 patients.A comprehensive search was conducted on the local Merseyside Haemato-Oncology Diagnostic Service database to identify new diagnosis of DLBCL between May 2013 and December 2015. Patients with a diagnosis of ‘diffuse large B-cell lymphoma’, ‘high grade B-cell non-Hodgkin’s lymphoma’ or ‘Burkitt’s lymphoma’ were included. Due to exposure of rituximab therapy influencing IHC, 18 patients with relapsed DLBCL were excluded and therefore only new cases were considered.Data pertaining to patients’ age, gender and Ann Arbor staging were collected including clinical data relating to all components of the IPI score, performance status, therapy … ER -