Prognostic Significance of BCL-2 and BCL-6 Expression in MYC-positive DLBCL

Linyu Li, Xuhan Zhang, Tingting Zhang, Zheng Song, Ge Hu, Wei Li, Lanfang Li, Lihua Qiu, Zhengzi Qian, Shiyong Zhou, Xianming Liu, Lixia Feng, Yi Pan, Qiongli Zhai, Bin Meng, Xiubao Ren, Kai Fu, Ping Wang, Xianhuo Wang, Huilai Zhang

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


We investigated the significance of BCL-2 and BCL-6 expression in MYC+ diffuse large B-cell lymphoma. Immunohistochemistry was performed to evaluate the expression of BCL-2, BCL-6, and MYC. BCL-2 played a more important role than MYC in patients with double-expression lymphoma. Besides, BCL-6 expression might also be a negative prognostic factor for such patients. Background: Double-expression lymphoma (DEL) is a rare subgroup of diffuse large B-cell lymphoma (DLBCL), which has coexpression of MYC and BCL-2. Coexpression of MYC and BCL-2 is considered a prognostic marker portending poor outcomes. However, the prognostic effect of BCL-2 and BCL-6 expression in DLBCL remains controversial. Materials and Methods: Immunohistochemical staining was performed to detect MYC, BCL-2 and BCL-6 expression in 212 patients with newly diagnosed DLBCL and assess the prognostic effects of BCL-2 and BCL-6 expression. The DLBCL patients were treated with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine [Oncovin], prednisone)–like regimens. Results: Retrospective analysis revealed that BCL-2+ and BCL-2+/MYC+ were prognostic factors indicative of poor outcomes. Patients with BCL-2+ and/or MYC+ expression had a poorer prognosis than that of patients with BCL-2 and/or MYC expression. Patients with BCL-2+/MYC expression showed a trend toward poorer survival than those with BCL-2/MYC+ expression, suggesting that BCL-2 plays a more important role than MYC. Also, patients with BCL-6/MYC+ expression had poorer progression-free survival than those with BCL-6+/MYC+ expression. In addition, patients with BCL-2+/MYC+/BCL-6 expression had the worst prognosis, suggesting that BCL-6 is a prognostic factor for poor outcomes for MYC+ DLBCL patients. Altogether, our findings have shown that BCL-2 is an independent prognostic factor and possibly plays a more important role than MYC in MYC+ DLBCL patients. Furthermore, we found that BCL-6 expression could also be a prognostic factor portending poor outcomes for MYC+ DLBCL patients.

Original languageEnglish (US)
Pages (from-to)e381-e389
JournalClinical Lymphoma, Myeloma and Leukemia
Issue number10
StatePublished - Oct 2018


  • Clinic
  • Diffuse large B-cell lymphoma
  • Double-expression lymphoma
  • Prognosis
  • Retrospective study

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research


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