Dr. Dogan on Updated WHO Classifications in DLBCL

Ahmet Dogan, MD, PhD, chief of Hematopathology Service, Departments of Pathology and Laboratory Medicine at Memorial Sloan Kettering Cancer Center, discusses the updated World Health Organization (WHO) classification and how it impacts treatment decisions for patients with diffuse large B-cell lymphoma (DLBCL).

In DLBCL, the new WHO classification introduces routine testing for activated B-cell and germinal center phenotypes, Dogan explains. These 2 phenotypes have different clinical outcomes and may respond differently to different therapies. This is determined with the use of immunohistochemistry (IHC) and the Hans algorithm. At the 2016 ASH Annual Meeting, novel molecular techniques were presented that may eventually replace IHC techniques for assignment of cell of origin.

Researchers have recently identified the significance of MEK, translocation, and the outcome of DLBCL. A study conducted out of The University of Texas MD Anderson Cancer Center showed that not only presence of translocation, but also extra copies of MEK, were associated with adverse outcomes. These patients appear to benefit from therapies that are more aggressive than R-CHOP. Therefore, testing for both MEK translocations and extra copies may be an important strategy for patients suffering from DLBCL, Dogan says.