Universität zu Köln

Graef, Claus Moritz, Goedel, Philipp, Falderbaum, Philipp, Balke-Want, Hyatt, Simon, Florian ORCID: 0000-0002-2700-3717, Sieg, Noelle, Naendrup, Jan-Hendrik, Neumann, Marie Anne-Catherine ORCID: 0000-0002-2396-6110, Gillessen, Sarah, Broeckelmann, Paul J., Eichenauer, Dennis A., Borchmann, Peter, von Tresckow, Bastian and Heger, Jan-Michel ORCID: 0000-0001-9463-8504 (2022). Impact of timing and precision of histopathological diagnosis on outcomes of patients with Burkitt lymphoma and high-grade B-cell lymphoma. Eur. J. Haematol., 108 (5). S. 403 - 413. HOBOKEN: WILEY. ISSN 1600-0609

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Abstract

Background Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL) are aggressive B-cell non-Hodgkin lymphomas (B-NHL) with a generally favorable prognosis after immunochemotherapy. The outcome of BL is superior to DLBCL. In 2016, a distinct group of lymphomas displaying characteristics of both BL and DLBCL (high grade B-cell lymphoma, HGBL) was introduced into the WHO classification. Histopathological discrimination of BL, DLBCL, and HGBL may be challenging. Data on the frequency of histopathological difficulties resulting in revision of the final diagnosis of BL/DLBCL/HGBL and its impact on the prognosis are limited. Methods We assessed histopathological features and clinical outcomes of 66 patients with suspected diagnosis of BL at the reporting institution between 2010 and 2020. Results The median age was 51 years (range 19-82) and final histopathological diagnosis revealed BL (n = 40), DLBCL (n = 12), or HGBL (n = 14). Patients with DLBCL and HGBL were either treated with DLBCL-directed (83.3% and 35.7%) or BL-directed (16.7% and 64.3%) protocols. Patients in whom diagnosis was revised from DLBCL to BL after initiation of DLBCL-directed treatment had a significantly inferior progression-free survival (PFS) than patients initially diagnosed with BL (p = 0.045), thus resembling rather the prognosis of DLBCL/HGBL. There was no difference between patients with DLBCL and HGBL, respectively, regarding PFS and OS (p = 0.38 and p = 0.27). Conclusion These results suggest that timely and precise histopathological diagnosis as well as reference histopathological review of the underlying lymphoma is critical to determine up-front treatment strategies. Consequently, selection of more aggressive treatment protocols in case of difficulties with discrimination between DLBCL/HGBL/BL may be a reasonable approach.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Graef, Claus Moritz UNSPECIFIED UNSPECIFIED UNSPECIFIED Goedel, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Falderbaum, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Balke-Want, Hyatt UNSPECIFIED UNSPECIFIED UNSPECIFIED Simon, Florian UNSPECIFIED orcid.org/0000-0002-2700-3717 UNSPECIFIED Sieg, Noelle UNSPECIFIED UNSPECIFIED UNSPECIFIED Naendrup, Jan-Hendrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Neumann, Marie Anne-Catherine UNSPECIFIED orcid.org/0000-0002-2396-6110 UNSPECIFIED Gillessen, Sarah UNSPECIFIED UNSPECIFIED UNSPECIFIED Broeckelmann, Paul J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Eichenauer, Dennis A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Borchmann, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED von Tresckow, Bastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Heger, Jan-Michel UNSPECIFIED orcid.org/0000-0001-9463-8504 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-681439
DOI:	10.1111/ejh.13747
Journal or Publication Title:	Eur. J. Haematol.
Volume:	108
Number:	5
Page Range:	S. 403 - 413
Date:	2022
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1600-0609
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BCL6 REARRANGEMENTS; CHOP CHEMOTHERAPY; MYC GENE; RITUXIMAB; CLASSIFICATION; PROGNOSIS; MULTICENTER; SURVIVAL; THERAPY Multiple languages Hematology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68143