Abstract
The Hans algorithm categorizes the diffuse large B-cell lymphoma (DLBCL) into two major subtypes: the germinal center B-cell-like (GCB) DLBCL and the non-GCB DLBCL. This classification is based on three immunohistochemical markers: CD10, BCL6, and MUM1. The non-GCB subtype is associated with lower overall survival (OS) and progression-free survival (PFS) rates compared to the GCB. DLBCL without positive staining for these three markers (CD10–, BCL6–, MUM1–), also called a triple negative or TN, are classified as the non-GCB subtype. However, they show different clinical characteristics and better prognosis than others assigned to the same cell-of-origin group. Herein, we report a case of a TN non-GCB DLBCL with a complete response after R-CHOP therapy. Together with previous reports of TN non-GCB DLBCLs, our case might depreciate the prognostic value of the Hans algorithm, which was already controversial in the literature, especially in the chemoimmunotherapy era.
Highlights
We report a case of a TN non-germinal center B-cell-like (GCB) Diffuse large B-cell lymphoma (DLBCL) (CD10−, BCL6−, MUM1−) with a complete response after chemoimmunotherapy
The Hans algorithm is known to be a substantial and reasonable strategy for determining the prognosis in DLBCL patients. It involves IHC staining for CD10, BCL6, and MUM1 to classify cases of DLBCL into the GCB and non-GCB groups [3]
Past studies have reported a significant correlation between the non-GCB subtype and lower overall survival (OS) and progression-free survival (PFS) compared with the GCB [6]
Summary
Diffuse large B-cell lymphoma (DLBCL) is the most frequently encountered type of non-Hodgkin lymphoma (NHL), representing 30% to 40% of all adult NHLs [1]. In spite of advancements in clinical responses due to the advent of rituximab, the mortality rate is close to 40% It is, essential to stratify patients conforming to its prognosis in an appropriate and cost-effective way. One category of DLBCL does not stain for the three markers CD10, BCL6, and MUM1, namely, the triple negative or TN (CD10−, BCL6−, MUM1−), which is classified as the non-GCB DLBCL subtype. It shows different clinical characteristics and a better prognosis than others assigned to the same cell-of-origin group. We report a case of a TN non-GCB DLBCL with a complete response after R-CHOP therapy
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