MYC and BCL 2 protein expression predicts survival in patients with diffuse large B ‐cell lymphoma treated with rituximab

Diffuse large B ‐cell lymphoma ( DLBCL ) is a heterogeneous disease and “double‐hit” DLBCL , with both MYC and BCL 2 translocations has a poor prognosis. In this study, we investigated whether MYC and BCL 2 protein expression in tissue would predict survival in DLBCL . The study included 106 cases of de novo DLBCL treated with rituximab and cyclophosphamide, doxorubicin, vincristine and prednisone (R‐ CHOP ) or CHOP ‐like regimens. The results were validated on an independent cohort of 205 DLBCL patients. Patients with low expression of BCL 2 (≤30%) and MYC (≤50%) had the best prognosis, whereas those with high BCL 2 (>30%) and MYC (>50%) had the worst outcome. In multivariate analysis, the combination of the BCL 2 and MYC was an independent predictor of overall survival ( OS ) and event‐free survival ( EFS ) ( P = 0·015 and P = 0·005, respectively). The risk of death was nine times greater for patients with high BCL 2 and MYC compared to those with low expression. High BCL 2 and MYC was a strong predictor of poor OS ( P