Impact of MYD88 Mutation Status on Histological Transformation of Waldenström Macroglobulinemia.
Fiche publication
Date publication
décembre 2019
Journal
American journal of hematology
Auteurs
Membres identifiés du Cancéropôle Est :
Dr CORNILLET-LEFEBVRE Pascale, Pr DELMER Alain
Tous les auteurs :
Zanwar S, Abeykoon JP, Durot E, King R, Perez Burbano GE, Kumar S, Gertz MA, Quinquenel A, Delmer A, Gonsalves W, Cornillet-Lefebvre P, He R, Warsame R, Buadi FK, Novak AJ, Greipp PT, Inwards D, Habermann TM, Micallef I, Go R, Muchtar E, Kourelis T, Dispenzieri A, Lacy MQ, Dingli D, Nowakowski G, Thompson CA, Johnston P, Thanarajasingam G, Bennani NN, Witzig TE, Villasboas J, Leung N, Lin Y, Kyle RA, Rajkumar SV, Ansell SM, Le-Rademacher JG, Kapoor P
Lien Pubmed
Résumé
Histological transformation in Waldenström macroglobulinemia (WM) is an uncommon complication, with limited data, particularly regarding the impact of MYD88 mutation on transformation. We examined risk factors and outcomes associated with transformation in WM, highlighting the role of MYD88 mutation. Patients with WM seen at Mayo Clinic, Rochester, USA and University Hospital of Reims, France, between 01/01/1996 and 12/31/2017 were included; 50 (4.3%) of 1147 patients transformed to a high-grade lymphoma, with median time-to-transformation of 4.5 (range 0-21) years in the transformed cohort. The MYD88 mutation status was known in 435/1147 (38%) patients (406 with non-transformed WM and 29 patients in transformed cohort). On multivariate analysis, MYD88 status alone was an independent predictor of transformation [odds ratio, 7(95%CI: 2.1-23); p=0.003]. Additionally, the MYD88 status was independently associated with shorter time-to-transformation [HR 7.9 (95%CI: 2.3-27; p=0.001)], with a 5-year transformation rate of 16% for MYD88 versus 2.8% with MYD88 mutated patients. Patients with transformation demonstrated a significant increase in risk of death compared to patients who did not transform (HR 5.075; 95%CI: 3.8-6.8; p<0.0001). In conclusion, the MYD88 status is an independent predictor of transformation and associated with a shorter time-to-transformation. Additionally, transformation conferred an inferior overall survival in patients with WM. This article is protected by copyright. All rights reserved.
Référence
Am. J. Hematol.. 2019 Dec 8;: