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Review
. 2023 Nov;60(5):267-276.
doi: 10.1053/j.seminhematol.2023.11.006. Epub 2023 Dec 1.

Biological heterogeneity in diffuse large B-cell lymphoma

Laura K Hilton  1 , David W Scott  2 , Ryan D Morin  3
Affiliations
Free article
Review

Biological heterogeneity in diffuse large B-cell lymphoma

Laura K Hilton et al. Semin Hematol. 2023 Nov.
Free article

Abstract

Diffuse large B-cell lymphoma (DLBCL) is heterogeneous both in clinical outcomes and the underlying disease biology. Over the last 2 decades, several different approaches for dissecting biological heterogeneity have emerged. Gene expression profiling (GEP) stratifies DLBCL into 3 broad groups (ABC, GCB, and DZsig/MHG), each with parallels to different normal mature B cell developmental states and prognostic implications. More recently, several different genomic approaches have been developed to categorize DLBCL based on the co-occurrence of tumor somatic mutations, identifying more granular biologically unified subgroups that complement GEP-based approaches. We review the molecular approaches and clinical evidence supporting the stratification of DLBCL patients based on tumor biology. By offering a platform for subtype-guided therapy, these divisions remain a promising avenue for improving patient outcomes, especially in subgroups with inferior outcomes with current standard-of-care therapy.

Keywords: Biomarkers; Genomics; LymphGen; Molecular subgroups; Precision medicine.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: DWS has consulted for Abbvie, AstraZeneca and Incyte and has research funding from Roche. DWS and RDM are named inventors on patents describing the use of gene expression profiling to subtype aggressive lymphoma, including one licensed to NanoString Technologies. RDM is an inventor on a patent related to biomarkers for non-Hodgkin lymphomas. LKH has nothing to declare.

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