Cell of origin (COO), BCL2/MYC status and IPI define a group of patients with Diffuse Large B-cell Lymphoma (DLBCL) with poor prognosis in a real-world clinical setting

Multiple studies have shown that cell of origin (COO) has an impact on overall prognosis in diffuse large B cell lymphoma (DLBCL), with the activated B-cell (ABC) as determined by gene expression profile (GEP) or non-GCB (germinal center B-cell) by immunocytochemistry (IHC) subgroup experiencing worse outcomes when treated with standard RCHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) chemo immunotherapy [1–5]. In contrast, the German Study group, failed to identify any differences in outcome between GCB and ABC subtypes of DLBCL [6]. Furthermore, two recent retrospective analyses also found that the non-GCB origin of this malignancy had no prognostic impact in patients with limited-stage DLBCL [7,8]. More, results from the recent Goya study once again confirmed that the assignment to COO subsets by NanoString has a prognostic impact with a significantly longer 3-year PFS for the GCB subtype [9]. In addition, a recent retrospective study has also confirmed that COO, determined by both GEP and IHC, is a strong predictor of survival in DLBCL