Extranodal diffuse large B‐cell lymphoma: Clinical and molecular insights with survival outcomes from the multicenter EXPECT study Article Swipe
Si‐Yuan Chen
,
Pengpeng Xu
,
Ru Feng
,
Cui Gan
,
Li Wang
,
Shu Cheng
,
Rongji Mu
,
Hui‐Lai Zhang
,
Xiaolei Wei
,
Song Yongping
,
Kaiyang Ding
,
Lihua Dong
,
Zunmin Zhu
,
Shen‐Miao Yang
,
Xin Wang
,
Tingbo Liu
,
Jianda Hu
,
Xiaoyun Zheng
,
Ou Bai
,
Jingyan Xu
,
Liang Huang
,
Wei Sang
,
Keqing Shi
,
Fan Zhou
,
Fei Li
,
Aibin Liang
,
Hui Zhou
,
Siguo Hao
,
Honghui Huang
,
Bing Xu
,
Wenbin Qian
,
Caixia Li
,
Zhiming Li
,
Chongyang Wu
,
Xiaobo Wang
,
Wenyu Shi
,
S. Wang
,
Yuyang Tian
,
Xi Zhang
,
Keshu Zhou
,
Li‐Juan Cui
,
Hui Liu
,
Huo Tan
,
Qing Leng
,
Donglu Zhao
,
Ting Niu
,
Weili Zhao
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1002/cac2.70033
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1002/cac2.70033
Background Diffuse large B‐cell lymphoma (DLBCL) is the most common subtype of aggressive non‐Hodgkin's lymphoma with distinct clinical and molecular heterogeneity. DLBCL that arises in extranodal organs is particularly linked to poor prognosis. This study aimed to determine the clinical and molecular characteristics of extranodal involvement (ENI) in DLBCL and assess the actual survival status of the patients. Methods In this population‐based cohort study, we investigated the clinical features of 5,023 patients newly diagnosed with DLBCL. Their clinical conditions, eligibility criteria, and sociodemographic details were recorded and analyzed. Gene panel sequencing was performed on 1,050 patients to discern molecular patterns according to ENI. Results The 2‐year overall survival (OS) rate was 76.2% [95% confidence interval (CI), 74.0%‐78.2%], and the 5‐year OS rate was 67.9% (95% CI, 65.2%‐70.4%). The primary treatment was immunochemotherapy with rituximab. Specific lymphoma involvement sites, especially the bones, bone marrow, and central nervous system, were identified as independent adverse prognostic factors. A high prevalence of non‐germinal center B‐cell (non‐GCB) phenotype and myeloid differentiation primary response 88 ( MYD88 )/ CD79B mutations were noted in lymphomas affecting the breasts, skin, uterus, and immune‐privileged sites. Conversely, the thyroid and gastrointestinal tract showed a low occurrence of non‐GCB phenotype. Remarkably, patients with multiple ENIs exhibited a high frequency of MYD88 , tet methylcytosine dioxygenase 2 ( TET2 ), CREB binding protein ( CREBBP ) mutations, increased MYD88 L265P and CD79B mutation (MCD)‐like subtypes, and poor prognosis. Genetic subtype‐guided immunochemotherapy showed good efficacy in subgroup analyses after propensity score matching with 5‐year OS and progression‐free survival rates of 85.0% (95% CI, 80.6%‐89.5%) and 72.1% (95% CI, 67.3%‐76.7%). Conclusions In the rituximab era, this large‐scale retrospective analysis from Asia confirmed the poor prognosis of DLBCL with multiple ENIs and underscored the efficacy of genetic subtype‐guided immunochemotherapy in treating extranodal DLBCL.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1002/cac2.70033
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/cac2.70033
- OA Status
- gold
- Cited By
- 2
- References
- 44
- Related Works
- 10
- OpenAlex ID
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Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4410267836Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1002/cac2.70033Digital Object Identifier
- Title
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Extranodal diffuse large B‐cell lymphoma: Clinical and molecular insights with survival outcomes from the multicenter EXPECT studyWork title
- Type
-
articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2025Year of publication
- Publication date
-
2025-05-08Full publication date if available
- Authors
-
Si‐Yuan Chen, Pengpeng Xu, Ru Feng, Cui Gan, Li Wang, Shu Cheng, Rongji Mu, Hui‐Lai Zhang, Xiaolei Wei, Song Yongping, Kaiyang Ding, Lihua Dong, Zunmin Zhu, Shen‐Miao Yang, Xin Wang, Tingbo Liu, Jianda Hu, Xiaoyun Zheng, Ou Bai, Jingyan Xu, Liang Huang, Wei Sang, Keqing Shi, Fan Zhou, Fei Li, Aibin Liang, Hui Zhou, Siguo Hao, Honghui Huang, Bing Xu, Wenbin Qian, Caixia Li, Zhiming Li, Chongyang Wu, Xiaobo Wang, Wenyu Shi, S. Wang, Yuyang Tian, Xi Zhang, Keshu Zhou, Li‐Juan Cui, Hui Liu, Huo Tan, Qing Leng, Donglu Zhao, Ting Niu, Weili ZhaoList of authors in order
- Landing page
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https://doi.org/10.1002/cac2.70033Publisher landing page
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/cac2.70033Direct link to full text PDF
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/cac2.70033Direct OA link when available
- Concepts
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Diffuse large B-cell lymphoma, Lymphoma, Medicine, Oncology, Overall survival, Internal medicineTop concepts (fields/topics) attached by OpenAlex
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2Total citation count in OpenAlex
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2025: 2Per-year citation counts (last 5 years)
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10Other works algorithmically related by OpenAlex
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