Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2023
Detection of Second Primary Lymphoma in Late Diffuse Large B-cell Lymphoma Recurrences.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Berendsen Madeleine R, Bladel Diede A G van, Hesius Eva, de Groot Fleur A, Kroeze Leonie I, Rijntjes Jos, Luijks Jeroen A C W, Hoevenaars Brigiet, Halilovic Altuna, Nooijen Peet, Bladel Esther van, Jonge-Peeters Susan de, Lensen Chantal, Pruijt Hans, van der Spek Ellen, Vermaat Joost S P, Hess Corine, Hebeda Konnie M, Stevens Wendy B C, van Krieken J Han J M, van den Brand Michiel, Groenen Patricia J T A, Scheijen Blanca
Аннотация
Approximately one-third of patients with diffuse large B-cell lymphoma (DLBCL) relapse and often require salvage chemotherapy followed by autologous stem cell transplantation. In most cases, the clonal relationship between the first diagnosis and subsequent relapse is not assessed, thereby potentially missing the identification of second primary lymphoma. In this study, the clonal relationship of 59 paired DLBCL diagnoses and recurrences was established by next-generation sequencing-based detection of immunoglobulin gene rearrangements. Among 50 patients with interpretable results, 43 patients (86%) developed clonally related relapsed disease. This was observed in 100% of early recurrences (<2 years), 80% of the recurrences with an interval between 2 and 5 years, and 73% of late recurrences (≥5 years). On the other hand, 7 (14%) out of 50 patients displayed different dominant clonotypes in primary DLBCL and clinical recurrences, confirming the occurrence of second primary DLBCL; 37% of DLBCL recurrences that occurred ≥4 years after diagnosis were shown to be second primary lymphomas. The clonally unrelated cases were Epstein-Barr virus positive in 43% of the cases, whereas this was only 5% in the relapsed DLBCL cases. In conclusion, next-generation sequencing-based clonality testing in late recurrences should be considered in routine diagnostics to distinguish relapse from second primary lymphoma, as this latter group of patients with DLBCL may benefit from less-intensive treatment strategies.