Patients with diffuse large B-cell lymphoma (DLBCL) who failed to achieve complete remission or relapsed ≤6 months after chemoimmunotherapy were analyzed to evaluate the response to salvage therapy and subsequent outcomes. The overall response rate to salvage therapy was 51% in an MYC-negative cohort, 50% in an MYC-positive single hit (SH) cohort, and 54% in an MYC-positive double-hit/triple-hit (DH/TH) cohort. Similarly, the proportion of patients undergoing HCT in each cohort was comparable. The 2-year survival was significantly longer in the MYC-negative cohort (29.9%) than both the MYC-positive SH cohort (0%) and the MYC-positive DH/TH cohort (9.9%). The 2-year survival in patients who underwent autologous HCT was similarly significantly longer in the MYC-negative cohort (55.4%) compared with the MYC-positive SH cohort (0%) and the MYC-positive DH/TH cohort (19.4%).
Patients with DLBCL who have had primary treatment failure have a similar response rate to salvage therapy regardless of MYC translocation status; however, those who are MYC-positive have very poor survival outcomes.