Clinical, molecular, and immunohistochemical features of testicular DLBCL
| . | All patients, n (%) . |
|---|---|
| Clinical features (n = 82)* | |
| Median age years (range) | 70 (26-93) |
| Age >60 y (n = 82) | 61 (74) |
| Stage (n = 81) | |
| Limited stage | 53 (65) |
| Advanced (extratesticular) stage | 28 (35) |
| B symptoms (n = 80) | 13 (16) |
| Performance status >2 (n = 81) | 17 (21) |
| Elevated LDH (n = 74) | 23 (31) |
| Extranodal sites >1 (n = 81) | 20 (25) |
| Bulky ≥10 cm (n = 80) | 7 (9) |
| IPI (n = 73) | |
| Low risk, 0, 1 | 36 (49) |
| Intermediate risk, 2, 3 | 24 (33) |
| High risk, 4, 5 | 13 (18) |
| CNS-IPI (n = 73) | |
| Low risk, 0, 1 | 9 (12) |
| Intermediate risk, 2, 3 | 43 (59) |
| High risk, ≥4 | 21 (29) |
| Curative-intent chemotherapy | 68 (83) |
| CHOP-like | 31 |
| R-CHOP | 37 |
| No or palliative chemotherapy† | 14 (17) |
| Prophylactic contralateral RT or orchiectomy (n = 82)‡ | 59 (72) |
| Adrenal and/or kidney involvement (n = 81) | 5 (6) |
| Any CNS relapse | 26 (32) |
| Parenchymal only | 18 |
| Parenchymal and leptomeningeal | 1 |
| Parenchymal and ocular | 1 |
| Leptomeningeal only | 6 |
| Molecular and immunohistochemical features (%)‡ | |
| Cell of origin | |
| Hans algorithm non-GCB | 49/82 (60) |
| Tally algorithm ABC | 76/82 (93) |
| MYD88 mutation positive‡ | 32/48 (67) |
| Limited stage | 16/26 (61.5) |
| Advanced (extratesticular) stage | 16/22 (73) |
| PDL1/2 rearrangement | 6/76 (8) |
| PDL1/2 amplification | 3/76 (4) |
| PDL1/2 gains | 24/76 (32) |
| PDL1-IHC (≥10%) | 9/82 (11) |
| PDL2-IHC (≥10%) | 37/82 (45) |
| BCL6 rearrangement | 17/75 (23) |
| BCL6 amplification | 3/74 (12) |
| BCL6 gains | 26/74 (35) |
| BCL6-IHC (≥30%) | 64/82 (78) |
| BCL2 rearrangement | 5/75 (7) |
| BCL2-IHC (≥50%) | 71/82 (87) |
| CIITA rearrangement | 7/76 (9) |
| HLA class II IHC ≥10% | 16/82 (19.5) |
| MYC rearrangement | 6/73 (7) |
| MYC and BCL2 and/or BCL6 rearrangement positive§ | 2/73 (3) |
| MYC-IHC (≥40%) | 15/82 (18) |
| MYC (≥40%) and BCL2 (≥50%) dual expression | 15/82 (18) |
| . | All patients, n (%) . |
|---|---|
| Clinical features (n = 82)* | |
| Median age years (range) | 70 (26-93) |
| Age >60 y (n = 82) | 61 (74) |
| Stage (n = 81) | |
| Limited stage | 53 (65) |
| Advanced (extratesticular) stage | 28 (35) |
| B symptoms (n = 80) | 13 (16) |
| Performance status >2 (n = 81) | 17 (21) |
| Elevated LDH (n = 74) | 23 (31) |
| Extranodal sites >1 (n = 81) | 20 (25) |
| Bulky ≥10 cm (n = 80) | 7 (9) |
| IPI (n = 73) | |
| Low risk, 0, 1 | 36 (49) |
| Intermediate risk, 2, 3 | 24 (33) |
| High risk, 4, 5 | 13 (18) |
| CNS-IPI (n = 73) | |
| Low risk, 0, 1 | 9 (12) |
| Intermediate risk, 2, 3 | 43 (59) |
| High risk, ≥4 | 21 (29) |
| Curative-intent chemotherapy | 68 (83) |
| CHOP-like | 31 |
| R-CHOP | 37 |
| No or palliative chemotherapy† | 14 (17) |
| Prophylactic contralateral RT or orchiectomy (n = 82)‡ | 59 (72) |
| Adrenal and/or kidney involvement (n = 81) | 5 (6) |
| Any CNS relapse | 26 (32) |
| Parenchymal only | 18 |
| Parenchymal and leptomeningeal | 1 |
| Parenchymal and ocular | 1 |
| Leptomeningeal only | 6 |
| Molecular and immunohistochemical features (%)‡ | |
| Cell of origin | |
| Hans algorithm non-GCB | 49/82 (60) |
| Tally algorithm ABC | 76/82 (93) |
| MYD88 mutation positive‡ | 32/48 (67) |
| Limited stage | 16/26 (61.5) |
| Advanced (extratesticular) stage | 16/22 (73) |
| PDL1/2 rearrangement | 6/76 (8) |
| PDL1/2 amplification | 3/76 (4) |
| PDL1/2 gains | 24/76 (32) |
| PDL1-IHC (≥10%) | 9/82 (11) |
| PDL2-IHC (≥10%) | 37/82 (45) |
| BCL6 rearrangement | 17/75 (23) |
| BCL6 amplification | 3/74 (12) |
| BCL6 gains | 26/74 (35) |
| BCL6-IHC (≥30%) | 64/82 (78) |
| BCL2 rearrangement | 5/75 (7) |
| BCL2-IHC (≥50%) | 71/82 (87) |
| CIITA rearrangement | 7/76 (9) |
| HLA class II IHC ≥10% | 16/82 (19.5) |
| MYC rearrangement | 6/73 (7) |
| MYC and BCL2 and/or BCL6 rearrangement positive§ | 2/73 (3) |
| MYC-IHC (≥40%) | 15/82 (18) |
| MYC (≥40%) and BCL2 (≥50%) dual expression | 15/82 (18) |
N = 82 patients. For clinical features, number in parentheses denotes total cases with information available. For the molecular and IHC features, counts are presented as a fraction, wherein the denominator denotes the number of cases for which a particular feature could be obtained. Rearrangement (break-apart) positive denotes a separation of the green and red signals or a loss of 1 signal in >5% of scored nuclei per case. Amplification denotes in excess of 4 fusion signals per nuclei, with >10% of nuclei having this signal pattern per case. Estimates are rounded.
Missing clinical information: stage, n = 1; B symptoms, n = 2, performance status, n = 1; lactose dehydrogenase, n = 8; mass size, n = 2; IPI/CNS-IPI, n = 9 PDL.
No chemotherapy or palliative chemotherapy: chemotherapy refusal, n = 7; frail, n = 6; CVP (cyclophosphamide, vincristine, prednisone) n = 1.
Failed MYD88 mutation analysis, n = 2; failed FISH analysis: BCL2, n = 7; BCL6, n = 7; PDL1/2, n = 6; MYC, n = 9, CIITA n = 6.
Double hit: MYC rearrangement/BCL2 rearrangement, n = 1; MYC rearrangement/BCL6 rearrangement, n = 1.