Impact of Induction Chemotherapy and Primary CNS Prophylaxis on Outcomes in High-Grade B-Cell Lymphoma with MYC and BCL2 and/or BCL6 Rearrangements (HGBL-DH/TH) or HGBL-NOS: An International Multi-Center Retrospective Analysis

Introduction High-grade B-cell lymphomas are a subgroup of lymphomas characterized by high-grade morphological appearances and the presence of rearrangements in MYC in addition to BCL2 and/or BCL6 (HGBL-DH/TH) or in the absence of cytogenetic changes, HGBL-NOS, previously described as B-cell lymphoma unclassifiable with features intermediate between diffuse large B-cell lymphoma and classical Burkitt's lymphoma (BCLU). These entities have been shown to have poorer outcomes from conventional treatment compared with diffuse large B cell lymphomas (DLBCL) not otherwise specified. One feature contributing to the poor prognosis of DHL is increased risk of central nervous system (CNS) involvement. Intensive chemotherapy regimens which include CNS prophylaxis may improve PFS in HGBL compared with R-CHOP-like therapy. Methods We conducted an international, multi-center retrospective analysis of HGBL-DH/TH/NOS and BCLU. The association between baseline clinical and histopathological characteristics and clinical outcome was assessed by Cox proportional hazards model, and variables with P