Significance of MYC/BCL2 Double Expression in Diffuse Large B-cell Lymphomas: A Single-center Observational Preliminary Study of 88 Cases

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Chutima Pinnark
Jerasit Surintrspanont
Thiamjit Chaichana
Jutamas Wongphoom
Yuda Chongpison
Shanop Shuangshoti
Thamathorn Assanasen


OBJECTIVES: To study the prevalence of MYC/BCL2 double expression in diffuselarge B-cell lymphomas (DLBCLs) and its prognostic value.

MATERIAL AND METHODS: This is a retrospective observational study, which includespatients diagnosed with DLBCLs at King Chulalongkorn Memorial Hospital from 2013 to2014. The slides were reviewed, and MYC and BCL2 immunostains were scored accordingto Revised WHO 2016 Classification. Clinical data were collected from medical records.Patients were divided into two groups: double expression (DE) and non-double expression(NDE). Survivals and hazard ratios (HR) were calculated.

RESULTS: Eighty-eight patients were included in the study and 40 (46%) had doubleexpression. The mean age was 60±16 years old; 40.9% were male and 59.1% werefemale. Eight patients were excluded from the survival analysis due to incompleteclinical data. Of the remaining 80 patients, there were 34 (42.5%) DE and 46 (57.5%)NDE. Median overall survival time (OS) and median progression-free survival time(PFS) tended to be lower in the DE group but was not statistically significant (Log-ranktest, p = 0.16). Multivariate analysis identified 4 confounders: sex, cell of origin (COO),risk group and addition of rituximab to the standard treatment. Adjusted HRs of the DEgroup were 1.21 (95%CI 0.63-2.31, p = 0.57) for OS and 1.20 (95%CI 0.63-2.30,p = 0.58) for PFS. In the germinal center subgroup (GCB) of DLBCL, patients with DEhad HRs of 4.33 (95%CI 0.80-23.37, p = 0.08, significance level of p < 0.10) for OS and4.61 (95%CI 0.80-23.37, p = 0.08) for PFS; but, these were not significant in the non-GCBsubgroup.

CONCLUSION: MYC/BCL2 double expression (DE) is significantly associated withpoorer prognosis than non-double expression (NDE) among DLBCLs with GCBphenotype. MYC/BCL2 double expression should be reported in the pathologicaldiagnosis of DLBCLs.


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Pinnark C, Surintrspanont J, Chaichana T, Wongphoom J, Chongpison Y, Shuangshoti S, Assanasen T. Significance of MYC/BCL2 Double Expression in Diffuse Large B-cell Lymphomas: A Single-center Observational Preliminary Study of 88 Cases. BKK Med J [Internet]. 2018Feb.20 [cited 2020Jul.15];14(1):16. Available from:
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