Prognostic Impact of Chromosomal Alterations of 3q27 on B-Cell Lymphoma.
Authors: Niitsu Nozomi , Okamoto Masataka , Nakamura Naoya , Aoki Sadao , Bessho Masami , Hirano Masami , Miura Ikuo 
Published: April 2020

Introduction: About 20–30% of diffuse large B-cell lymphomas (DLBCL) have chromosomal translocations affecting 3q27/BCL6. Although the 3q27 rearrangements are the most frequent aberrations among DLBCL, the clinical impact on the prognosis remains to be settled. We evaluated the clinical characteristics and prognoses of patients with B-cell lymphoma carrying 3q27 translocations.

Patients and Methods: A total of 1388 consecutive patients with non-Hodgkin’s lymphoma were treated at ALTSG from 1998 to 2004. Chromosomal data were available in 511 of 1,059 patients with B-cell lymphoma. Patients with DLBCL were treated with cyclophosphamide, vincristine, bleomycin, etoposide, doxorubicin, and prednisolone (CyclOBEAP) regimen.

Results (Table 1, 2): Among 53 patients having 3q27 rearrangements, 10 of 59 patients (10.4%) were follicular lymphoma (FL) (grade 2, 5 patients; grade 3a 2 patients; grade 3b 3 patients). Translocation partners of 5 patients were an immunoglobulin gene (IG type) loci, 4 patients with t(3;14)(q27;q32) and 1 patient with t(3;22)(q27;q11).. Two cases did not involve immunoglobulin gene (non-IG type), t(2,3)(q23;q27) and t(3;6)(q27;p21). The translocation partner was not identified in 3 patients. In 3 of 10 patients, t(14;18)(q32;q21.3) was also observed in addition to 3q27 translocation. Among 39 of 173 patients (22.5%) with DLBCL, 16 patients had translocations with t(3;14) and 3 patients with t(3;22). Non-IG type was observed in 1 patient of t(1;3)(p34;q27) and 19 of der(3)(q27). Besides 3q27 changes, 3 patients had t(14;18), 2 had t(8;14)(q24;q32), 2 had t(11;14)(q13;q32), and 5 had add(17)(p11). 3q27 translocations were observed significantly higher among patients &gt; 60 years and among patients with an advanced stage. Bone marrow infiltration was found in 13 of the 39 DLBCL patients. The prognostic significance was not found between FL and DLBCL with 3q27 translocations. In addition, progression-free survival (PFS) rates were significantly longer in patients with 3q27 translocation than in those with 18q21 translocation with FL patients. PFS were significantly longer in patients with 3q27 translocation-positive DLBCL patients, and did not have the significant difference between IG type and non-IG types

Conclusions: DLBCL patients with 3q27 translocation had better prognosis despite the high-risk group according to the IPI. These findings suggest that the presence of 3q27 translocation is a significant prognostic factor in DLBCL.

Table 1 Overall Survival and PFS n CR (%) 5 yrs OS (%) 5 yrs PFS DLBCL 173 127 (73) 72 52.1 3q27 translocation 39 32 (82) 64.1 60.1     IG type 19 15 (79) 41.8 41.6     Non-IG type 20 17 (85) 87.1 67.6 18q21 translocation 17 12 (71) 85.7 7.1 Other translocations 117 83 (71) 40.7 40.8 OS Log-Rank 0.578 Wilcoxson 0.616 PFS Log-Rank 0.046 Wilcoxson 0.007

Table 2 Characteristics of DLBCL with 3q27 translocation 3q27 translocation 18q21.3 translocation other abnormality p-value (n=39) (n=17) (n=117) Age; median (range) 68 (46–67) 60 (42–72) 65(20–87) N.S. Gender; M/F 28/11 9/8 55/62 0.027 PS; 0,1/2–4 25/14 9/8 79/40 N.S. Stage; I,II/III,IV 10/29 3/14 48/71 0.047 LDH; N/&gt;N 6/33 3/14 29/92 N.S. Bulky mass; present 10 8 32 N.S. BM involvement :present 13 6 47 N.S. IPI: L/L-I/H-I/H 3/12/14/10 1/4/7/5 19/38/48/16 N.S. CR 32 (82%) 12 (71%) 83(71%) N.S.