Trial reportHematological oncology2020
Immunohistochemistry for c-myc and bcl-2 overexpression improves risk stratification in primary central nervous system lymphoma.
Trial report in Hematological oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 28 citations in OpenAlex.
- Immunohistochemistry for c-myc and bcl-2 overexpression improves risk stratification in primary central nervous system lymphoma.Hematological oncology · 2020Trial
- Unraveling the immune microenvironment in primary CNS lymphoma.Biomarker research · 2026Review
- Article
- Preoperative phenotypic stratification of primary central nervous system lymphoma using multiparametric MRI-based radiomics: prediction of germinal center B-cell-like and double-expression status.Frontiers in oncology · 2026Article
- Prediction of double expression status of primary CNS lymphoma using multiparametric MRI radiomics combined with habitat radiomics: a double-center study.Journal of neuro-oncology · 2025Article
- Assessment of Expressor Lymphoma Prevalence in High-Grade Large B-cell Lymphomas: An Observational Analysis From a Tertiary Care Centre.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2025Article
- Efficacy and safety of the R2-MTX regimen in primary central nervous system lymphoma (PCNSL): a single-center retrospective analysis.Journal of cancer research and clinical oncology · 2025Article
- Dynamic susceptibility contrast perfusion MRI helps in differentiating double-expressor from non-double-expressor subtypes in primary central nervous system lymphoma.Neuroradiology · 2025Article
- Clinicopathological risk factors for prognosis and therapeutic response of primary central nervous system lymphoma in China: a single-center retrospective analysis of 118 cases.Annals of hematology · 2025Article
- Machine learning-based pathomics signature of histology slides as a novel prognostic indicator in primary central nervous system lymphoma.Journal of neuro-oncology · 2024Article
- [Clinicopathologic characteristics and survival analysis of primary large B-cell lymphoma of the central nervous system].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2024Article
- Impact of MYC and BCL2 double expression on outcomes in primary CNS lymphoma: a UK multicenter analysis.Blood advances · 2024Article
- O-6-Methylguanine-DNA Methyltransferase, C-MYC, and EBER Status in Diffuse Large B-Cell Lymphoma of Central Nervous System.International journal of molecular and cellular medicine · 2024Article
- Extranodal lymphoma: pathogenesis, diagnosis and treatment.Molecular biomedicine · 2023Review
- Clinicopathological risk factors for a poor prognosis of primary central nervous system lymphoma in elderly patients in the Tohoku and Niigata area: a multicenter, retrospective, cohort study of the Tohoku Brain Tumor Study Group.Brain tumor pathology · 2022Article
- Novel insights into the biomarkers and therapies for primary central nervous system lymphoma.Therapeutic advances in medical oncology · 2022Review
- Double-Expressor Appendiceal Burkitt's Lymphoma: A Case Report and Literature Review.Case reports in hematology · 2022Article
- Primary central nervous system lymphomas express immunohistochemical factors of autophagy.Scientific reports · 2021Article
- Diagnosis, prognosis and treatment of primary central nervous system lymphoma in the elderly population (Review).International journal of oncology · 2021Review
- Prognostic Role of Blood Markers in Primary Central Nervous System Lymphoma Patients Treated With High-Dose Methotrexate-Based Therapy.Frontiers in oncology · 2021Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Overexpression of bcl-2 and c-myc are defining features of double-expressor-lymphoma (DEL) but may also occur separately in patients with primary central nervous system lymphoma (PCNSL). Despite all progress in optimizing treatment regimen, there is lack of sufficient risk stratification models. Here, we first describe the relationship between DEL biology, the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI), treatment response, disease progression, and mortality in PCNSL. In this study, we determined c-myc and bcl-2 status immunohistochemically in samples of 48 patients with newly diagnosed PCNSL and followed these patients for a median interval of 6.2 years. Twelve, 18, and 17 patients harbored none, one, or both DEL features. Corresponding overall response rates after first-line therapy were strongly associated with DEL biology (100%, 42%, and 44% in patients with 0, 1, or 2 DEL features). Patients with one or both DEL features had a 5-fold and 13-fold higher 5-year risk of progression and/or death than patients without DEL features. These associations prevailed after adjusting for the NCCN-IPI. DEL improved the discriminatory capability of the NCCN-IPI (P = .0001). Furthermore, we could show that addition of DEL biology to the NCCN-IPI significantly improved the score's discriminatory potential both toward progression-free survival (increase in Harell's c = 0.15, P = .005) and overall survival (increase in Harell's c = 0.11, P = .029). In conclusion, DEL biology is a strong and simple-to-use predictor of adverse outcome in PCNSL. Addition of DEL to the NCCN-IPI improves its prognostic potential. Disease progression from PCNSL harboring both DEL features is invariably fatal. This defines a novel PCNSL patient subset with a great unmet need for improved therapy.
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