Cell of origin of transformed follicular lymphoma

摘要: Follicular lymphoma (FL) is an indolent disease but transforms in 2% to 3% of patients per year into aggressive, large cell lymphoma, a critical event the course associated with increased lymphoma-related mortality. Early transformation cannot be accurately predicted at time FL diagnosis and biology transformed (TFL) poorly understood. Here, we assembled cohort 126 diagnostic specimens including 40 experiencing (<5 years) 86 not for least 5 years. In addition, overlapping 155 TFL patients, 114 cases which paired samples were available, assessed temporal changes routinely available biomarkers, outcome after transformation, as well molecular subtypes TFL. We report that expression IRF4 independent predictor early (Hazard ratio, 13.3; P < .001). also show composite histology predicts favorable prognosis. Moreover, applying Lymph2Cx digital gene assay diffuse B-cell (DLBCL) cell-of-origin determination 110 DLBCL-like TFL, demonstrate germinal-center B-cell–like subtype majority (80%) significant proportion activated (ABC) (16%). These latter are commonly negative BCL2 translocation arise preferentially from translocation-negative and/or IRF4-expressing FLs. Our study demonstrates existence heterogeneity its relationship antecedent FL.