Research of the immunfenotipically, cytogenetically caracteristics in R-CHOP, CHOP treated diffuse large B cell lymphomas and impact of this caracteristics to the survival rate

Aim: Diffuse Large B cell lymphomas (DLBCL) is the mostly encountered Non-Hodgkin lymphoma hystologic subtype for the adults. It shows heterogeneity clinically, morphologically, immunophenotypically and cytogenetically. Because of this reason, they have different clinical course and survival. Although more than half of the patients are cured with a combination of rituximab with anthracycline-based chemotherapy, such as the R-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab; immunochemotherapy) regimen. The treatment responses are varied and many patients die of their disease. The aim of this study is; to show the characteristics of R-CHOP, CHOP treated DLBCL and also to study the relationship of the MYC,BCL2,BCL6 translocation and BCL2, CD5, Siklin D1, Ki67 protein expression with the clinicopathological parameters and to reveal the influence of this relationship on prognosis and survival. Methods: In our study; 268 R-CHOP, CHOP treated DLBCL cases were investigated. Bcl-6, CD10, MUM1, Bcl-2, CD5, Siklin D1 and Ki-67 expressions are specified by immunhistochemical methods. MYC, BCL2 and BCL6 gen rearrangement presence is studied with the Florescent Insitu Hybridization (FISH) method. The influence of these immunofenotipic and cytogenetic caracteristics on prognosis and survival were investigated. Results: When the relationships between the age, sex, localization and subtype of the cases and their survivals compared; it was meaningful that the nodal DBBHL survival rate was higher statistically (p=0.011). In addition to this, MYC, BCL2, BCL6 gen rearrangement is determined with 18 cases (6.7%) and the presence of MYC gen rearrangement was associated with significantly worse overall survival (p=0.021). The cases which was identified as Double Hit and Triple Hit lymphoma has statistically short survival rate (p=0.044). Also these cases showed high Ki67 proliferation rate (p=0.005). For all cases no meaningful result could be found statistically between BCL2, CD5, Siklin D1 protein expression, high Ki67 proliferation rate, BCL6, BCL2 rearrangement and the survival. Conclusion: DLBCL's have different clinical course, treatment response and survival, because of the fact that they form a heterogeneous group histomorphologically and genetically. These genetic differences should be revealed in order to specify the effective treatments and to extend the survival. For this purpose; there is need for similar studies to determine favorable therapeutic approaches. Key words: Diffuse Large B cell Lymphoma, Double Hit Lymphoma, Triple hit lymphoma, MYC, BCL2, BCL6 rearrangement. Survival analysis.