The Complexity and Challenges of Translating the Dark Zone Signature into Immunohistochemistry in Diffuse Large B-Cell Lymphoma - PubMed
5 hours ago
- #Immunohistochemistry
- #Diffuse large B-cell lymphoma
- #Dark Zone Signature
- DLBCL/HGBCL-MYC/BCL2 is a distinct disease entity with poor prognosis, diagnosed via MYC and BCL2 rearrangement by FISH.
- The dark zone signature (DZsig) identifies a gene expression profile for DLBCL/HGBCL-MYC/BCL2, including both double-hit and non-double-hit cases.
- GEP analysis is not widely applicable due to cost and equipment constraints, prompting the need for simpler surrogate methods like IHC.
- A two-step IHC algorithm (Hans classifier plus MYC, ALOX5, LMO2 antibodies) was developed to detect DZsig, achieving 76.2% sensitivity and 95.5% specificity.
- The DZ-IHC algorithm showed similar 5-year overall survival rates to GEP assays but has suboptimal PPV, requiring further refinement for clinical use.