Background Double-expressor lymphoma (DEL), defined as cases with concurrent MYC and BCL2 proteins overexpression, is associated with poor prognosis when treated with R-CHOP alone. Prognostic data on DEL treated with intensive treatment are limited and controversial.
Methods We retrospectively report our experiences about 221 consecutive de-novo diffuse large B cell lymphoma patients and analyze the role of intensive therapies for 65 patients with DEL.
Results No significant difference in clinical characteristics and survival outcomes between DEL and non-DEL was observed. Overall, 32 (76.2%) and 20 (87.0%) patients with DEL received R-CHOP and intensive treatment achieved partial response or complete response, respectively. Intensive therapies may improve the prognosis over R-CHOP in patients with DEL (P = 0.029 for PFS, P = 0.026 for OS). Subgroup analysis according to clinical characteristics showed intensive therapies resulted in better prognosis than R-CHOP regimen in DEL patients aged under 60 years (P = 0.004 for PFS; P =0.090 for OS), whereas no significant superiority was found in DEL patients aged over 60 years (P = 0.646 for PFS; P = 0.361 for OS).
Conclusions This second Chinese cohort study suggests that intensive immunochemotherapy may have the ability to improve the prognosis of young patients with DEL.