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. 2024 Feb 27;8(4):968-977.
doi: 10.1182/bloodadvances.2023010704.

MYC rearrangements in HIV-associated large B-cell lymphomas: EUROMYC, a European retrospective study

Chiara Pagani  1 , Chiara Rusconi  2 , Alessia Dalla Pria  3 , Emanuele Ravano  4 , Philipp Schommers  5 , Mariana Bastos-Oreiro  6 , Luisa Verga  7 , Guido Gini  8 , Michele Spina  9 , Luca Arcaini  10   11 , Sara Steffanoni  12 , Davide Dalu  13 , Lara Crucitti  4 , Luisa Lorenzi  14 , Piera Balzarini  14 , Chiara Cattaneo  1 , Lucia Bongiovanni  15   16 , Andreas Rosenwald  17 , Fabio Facchetti  14 , Mark Bower  3 , Andrés J M Ferreri  12   16 , Giuseppe Rossi  1 , Alessandra Tucci  1 , Alessandro Re  1
Affiliations

MYC rearrangements in HIV-associated large B-cell lymphomas: EUROMYC, a European retrospective study

Chiara Pagani et al. Blood Adv. .

Abstract

Large B-cell lymphoma (LBCL) carrying MYC rearrangement, alone or together with BCL2 and/or BCL6 translocations, have shown a poor prognosis when treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in the HIV population. Scanty data are available on the prevalence and prognostic impact of MYC rearrangements in HIV-associated LBCL. We conducted a retrospective study to evaluate the clinical effect of MYC rearrangement in HIV-associated LBCL. We evaluated clinical characteristics, treatment received, and outcome of LBCL in patients with HIV with MYC rearrangement (MYC+) and without MYC rearrangement (MYC-). A total of 155 patients with HIV who had received fluorescence in situ hybridization analysis for MYC were enrolled in 11 European centers: 43 with MYC+ and 112 MYC-. Among patients with MYC, 10 had double-/triple-hit lymphomas, and 33 had isolated MYC rearrangement (single-hit lymphoma). Patients with MYC+ had more frequently advanced stage, >2 extranodal site at presentation, and higher proliferative index. There were no significant differences in overall survival and progression-free survival (PFS) between the 2 groups. However, patients with MYC+ received more frequently intensive chemotherapy (iCT) (44%) than (R)CHOP alone (35%) or infusional treatment (DA-EPOCH-R and R-CDE) (19%). Among patients with MYC+, those who received iCT achieved a better outcome than patients who received nonintensive treatment (complete remission, 84% vs 52%; P = .028; 5-year PFS, 66% vs 36%; P = .021). Our retrospective results suggest that HIV-associated LBCL with MYC+ could be considered for an intensive therapeutic approach whenever possible, whereas (R)CHOP seems to give inferior results in this subset of patients in terms of complete remission and PFS.

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Conflict of interest statement

Conflict-of-interest disclosure: M.S. reports honoraria from Gilead, Servier, Novartis, Incyte, BeiGene, and Istituto Gentili; and research funding from Menarini. L.A. reports consultancy fees from or advisory role in Roche, Janssen-Cilag, Verastem, Incyte, EUSA Pharma, Celgene/Bristol Myers Squibb, Kite/Gilead, and ADC Therapeutics; speakers’ bureau fees from EUSA Pharma and Novartis; and research funding from Gilead Sciences. D.D. reports travel grants from Roche, Gentili, Lilly, and Eisai; and other remuneration from Gentili and Daikii Sanchio. The remaining authors declare no competing financial interests.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
OS and PFS according to MYC status. OS (A) and PFS (B) of patients with MYC+ and those with MYC– (P not significant).
Figure 2.
Figure 2.
OS and PFS in SHL and DHL-THL lymphoma. OS (A) and PFS (B) of “single-hit” and “double-triple hit” lymphomas (P = .145 for OS; and P = .045 for PFS between 2 groups).
Figure 3.
Figure 3.
OS and PFS in patients with MYC+ according to treatment received. OS (A) and PFS (B) according to treatment received in MYC+ group (P = .021 for PFS between intensified and not intensified therapy; P was not significant for OS).
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