The overexpression of MYC protein is a predictor of poor prognosis in patients with bulky mass diffuse large B-cell lymphoma (DLBCL), according to a new study published in the journal Cancer Medicine. This is especially the case for patients in the high-risk group and those with the germinal center B-cell–like type disease. The study authors also suggested that consolidation radiotherapy for residual disease following induction therapy “may improve outcomes” for these patients.

There is limited prognostic data for patients with bulky mass DLBCL. A bulky mass is defined as a maximum tumor at least 7.5  cm in diameter. 

Read more about the prognosis of DLBCL

In the present study, a team of researchers from China analyzed the prognostic value of MYC expression and other biological parameters in 227 patients with bulky mass DLBCL.

The 1-year overall survival rate of the patients was 72.7% while the 3-year overall survival rate was 57.1%. 

The 1-year progression-free survival rate was 52% while the 3-year progression-free survival rate was 42.5%. 

In 140 patients in whom the MYC protein was overexpressed, the overall and progression-free survival rates were significantly shorter. 

Subgroup analyses demonstrated that MYC overexpression was associated with worse overall and progression-free survival rates in patients with an International Prognostic Index score of 3 to 5, Ann Arbor stage 3 to 4, and germinal center B-cell-like subtype. 

Consolidation radiotherapy improved overall and progression-free survival rates in all patients regardless of MYC expression level. 

“The prognostic value of MYC overexpression was maintained in a multivariate model adjusted for the International Prognostic Index,” the researchers reported. “Further investigation and prospective studies in patients with bulky mass DLBCL are warranted.”

DLBCL is characterized by B cells infiltrating tissues and organs in a widespread, diffuse pattern. Disease prognosis is based on 5 clinical factors, which are the patient’s age, disease stage, extra-nodal site number, performance status, and lactate dehydrogenase level.


Wang Y, Liu D, Zhang X, et al. MYC overexpression but not MYC/BCL2 double expression predicts survival in bulky mass diffuse large B-cell lymphoma patients. Cancer Med. Published online August 28, 2023. doi:10.1002/cam4.6463