{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:38:48Z","timestamp":1791571128381,"version":"4.3.4"},"reference-count":37,"publisher":"American Association for the Advancement of Science (AAAS)","issue":"8","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Shanghai Clinical Research Center for Cell Therapy","award":["23J41900100"],"award-info":[{"award-number":["23J41900100"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82130004"],"award-info":[{"award-number":["82130004"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC2502600"],"award-info":[{"award-number":["2022YFC2502600"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Commun"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Diffuse large B\u2010cell lymphoma (DLBCL) is the most common subtype of aggressive non\u2010Hodgkin's lymphoma with distinct clinical and molecular heterogeneity. DLBCL that arises in extranodal organs is particularly linked to poor prognosis. This study aimed to determine the clinical and molecular characteristics of extranodal involvement (ENI) in DLBCL and assess the actual survival status of the patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">In this population\u2010based cohort study, we investigated the clinical features of 5,023 patients newly diagnosed with DLBCL. Their clinical conditions, eligibility criteria, and sociodemographic details were recorded and analyzed. Gene panel sequencing was performed on 1,050 patients to discern molecular patterns according to ENI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The 2\u2010year overall survival (OS) rate was 76.2% [95% confidence interval (CI), 74.0%\u201078.2%], and the 5\u2010year OS rate was 67.9% (95% CI, 65.2%\u201070.4%). The primary treatment was immunochemotherapy with rituximab. Specific lymphoma involvement sites, especially the bones, bone marrow, and central nervous system, were identified as independent adverse prognostic factors. A high prevalence of non\u2010germinal center B\u2010cell (non\u2010GCB) phenotype and myeloid differentiation primary response 88 (\n                      <jats:italic toggle=\"yes\">MYD88<\/jats:italic>\n                      )\/\n                      <jats:italic toggle=\"yes\">CD79B<\/jats:italic>\n                      mutations were noted in lymphomas affecting the breasts, skin, uterus, and immune\u2010privileged sites. Conversely, the thyroid and gastrointestinal tract showed a low occurrence of non\u2010GCB phenotype. Remarkably, patients with multiple ENIs exhibited a high frequency of\n                      <jats:italic toggle=\"yes\">MYD88<\/jats:italic>\n                      , tet methylcytosine dioxygenase 2 (\n                      <jats:italic toggle=\"yes\">TET2<\/jats:italic>\n                      ), CREB binding protein (\n                      <jats:italic toggle=\"yes\">CREBBP<\/jats:italic>\n                      ) mutations, increased\n                      <jats:italic toggle=\"yes\">\n                        MYD88\n                        <jats:sup>L265P<\/jats:sup>\n                      <\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">CD79B<\/jats:italic>\n                      mutation (MCD)\u2010like subtypes, and poor prognosis. Genetic subtype\u2010guided immunochemotherapy showed good efficacy in subgroup analyses after propensity score matching with 5\u2010year OS and progression\u2010free survival rates of 85.0% (95% CI, 80.6%\u201089.5%) and 72.1% (95% CI, 67.3%\u201076.7%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In the rituximab era, this large\u2010scale retrospective analysis from Asia confirmed the poor prognosis of DLBCL with multiple ENIs and underscored the efficacy of genetic subtype\u2010guided immunochemotherapy in treating extranodal DLBCL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cac2.70033","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T08:49:22Z","timestamp":1748335762000},"page":"919-935","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Extranodal diffuse large B\u2010cell lymphoma: Clinical and molecular insights with survival outcomes from the multicenter EXPECT study"],"prefix":"10.34133","volume":"45","author":[{"given":"Si\u2010Yuan","family":"Chen","sequence":"first","affiliation":[{"name":"Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, P. R. China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng\u2010Peng","family":"Xu","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, P. R. China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ru","family":"Feng","sequence":"additional","affiliation":[{"name":"Nanfang Hospital of Southern Medical University","place":["Guangzhou, P. R. China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo\u2010Hui","family":"Cui","sequence":"additional","affiliation":[{"name":"Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, P. R. 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