International Journal of Hematology and Oncology 2022, Vol 32, Num 2 Page(s): 016-022
Impact of K-ras Mutation and C-myc Overexpression on the Prognosis of Diffuse Large B-Cell Lymphomas

Sule KETENCI ERTAS1, Ali UNAL2, Hilal AKALIN3, Munevver BARAN4, Ozlem CANOZ4, Olgun KONTAS4, Yusuf OZKUL5, Muzaffer KEKLIK2, Serdar SIVGIN6, Bulent ESER7, Leylagul KAYNAR2, Mustafa CETIN8

1Kayseri City Training and Research Hospital, Department of Rheumatology, Kayseri, TURKEY
2Erciyes University, Faculty of Medicine, Department of Hematology, Kayseri, TURKEY
3Ahi Evran University, Department of Medical Genetics, Kırşehir, TURKEY
4Erciyes University, Faculty of Medicine, Department of Pathology, Kayseri, TURKEY
5Erciyes University, Faculty of Medicine, Department of Medical Genetics, Kayseri, TURKEY
6Acıbadem Hospital, Department of Hematology, Kayseri, TURKEY
7Medical Park Hospital, Department of Hematology, Antalya, TURKEY
8Medstar (Memorial) Hospital, Department of Hematology, Antalya, TURKEY

Keywords: Lymphoma, K-ras, C-myc
Diffuse large B-cell lymphoma(DLBCL) is the prototype of aggressive lymphomas. The abnormalities such as translocation, deletion, duplication are stated to affect the progress and the prognosis of the disease. This study investigates the presence and impact on the prognosis of K-ras mutation and C-myc overexpression in patients with DLBCL. Twenty eight patients diagnosed with DLBCL and 29 healthy controls, whose diagnostic lymph node biopsy was reactive, were enrolled in this study. Paraffin blocks were analyzed for K-ras mutations and C-myc expressions. The effects of C-myc and K-ras on overall and disease-free survival were evaluated. Of the 28 patients, three (10.7%) K-ras mutations were detected. K-ras mutation (+) cases have an average survival time of 28 months, while those without the mutation were 49 months. The average duration of disease-free survival was 17.6 months in patients with K-ras mutation, while it has been identified as 45 months in patients without mutations (p= 0.072). C-myc overexpression in 17 patients(61%) was detected. Median overall survival was 33 months in male patients, while it was 65 months in female patients (p= 0.006). The median disease-free survival time was 23 months in male patients, although 64 months in female patients (p= 0.003). Complete remission rate was 30% in C-myc overexpression group, while 69% in remaining group with the cut-off 2.48 (p= 0.02). The presence of K-ras and C-myc overexpression in patients with DLBCL does not affect overall and disease-free survival. C-myc overexpression harms complete remission. Gender was found to be influential on the overall and disease-free survival; meanwhile, the female gender was a better prognosis.