{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T10:56:39Z","timestamp":1790679399947,"version":"4.1.0"},"reference-count":64,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HemaSphere"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Prediction of the outcome of large B\u2010cell lymphomas\/high\u2010grade B\u2010cell lymphomas (DLBCLs\/HGBCLs) is based on clinical parameters and molecular testing, for example, for rearrangements of MYC (MYC\u2010R) and MYC\u2010R in combination with BCL2 and BCL6 translocations (double\/triple hit). However, the group of DLBCL\/HGBCL with poor outcome is not confined to MYC\u2010R lymphomas, and fluorescence in situ hybridization (FISH) testing for MYC\u2010R misses several high\u2010risk lymphomas. We aimed to understand if artificial intelligence (AI) trained to identify MYC\u2010R will delineate a poor prognostic subgroup. We generated a collection of digital hematoxylin and eosin (H&amp;E)\u2010stained slides of DLBCL\/HGBCL (\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u20092018) annotated for MYC, BCL2, and BCL6 translocations. A multiple\u2010instance deep learning AI model for the identification of MYC\u2010R alone or as double\/triple hit was established using 1035 H&amp;E\u2010stained slides and evaluated on an external test cohort (\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u2009499). A pretrained tumor tissue classifier improved reliability and interpretability by focusing the model on tumor areas. Our model score reflects a morphological \u201cMYCness\u201d in DLBCL\/HGBCL and demonstrates a strong association with overall survival (OS) and progression\u2010free survival (PFS) in the external test cohort. This was confirmed with an additional clinical test cohort (\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u2009484) without FISH labels. The AI model scores correlate with various molecular features of DLBCL\/HGBCL, including BCL2 and MYC gene expression, and the high\u2010grade gene expression signature, but also features of the tumor microenvironment. Multivariate analysis, adjusted for International Prognostic Index (IPI) factors, demonstrated the prognostic significance of our model in identifying high\u2010risk cases for both PFS and OS.\n                  <\/jats:p>","DOI":"10.1002\/hem3.70463","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:06:51Z","timestamp":1788185211000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["AI for prognostic assessment of diffuse large B\u2010cell lymphoma using H&amp;E whole\u2010slide images"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9492-3255","authenticated-orcid":false,"given":"Jonas","family":"Lippl","sequence":"first","affiliation":[{"name":"Department of Medical Bioinformatics University Medical Center G\u00f6ttingen G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Reinke","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hematopathology Section University Hospital Schleswig\u2010Holstein, Campus Kiel Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Schrod","sequence":"additional","affiliation":[{"name":"Department of Statistical Genomics and Systems Genetics European Molecular Biology Laboratory (EMBL) Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Wolfseher","sequence":"additional","affiliation":[{"name":"Department of Statistical Bioinformatics University of Regensburg Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"H\u00fcttl","sequence":"additional","affiliation":[{"name":"Department of Statistical Bioinformatics University of Regensburg Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Huttner","sequence":"additional","affiliation":[{"name":"Department of Statistical Bioinformatics University of Regensburg Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette M.","family":"Staiger","sequence":"additional","affiliation":[{"name":"Department of Pathology Robert Bosch Hospital Stuttgart Stuttgart Germany"},{"name":"Dr Margarete Fischer\u2010Bosch Institute of Clinical Pharmacology Stuttgart Germany"},{"name":"University of Tuebingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilske","family":"Oschlies","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hematopathology Section University Hospital Schleswig\u2010Holstein, Campus Kiel Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karoline","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hematopathology Section University Hospital Schleswig\u2010Holstein, Campus Kiel Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward G.","family":"Michaelis","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hematopathology Section University Hospital Schleswig\u2010Holstein, Campus Kiel Kiel Germany"},{"name":"Department of Pathology Charit\u00e9 University Hospital Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Richter","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hematopathology Section University Hospital Schleswig\u2010Holstein, Campus Kiel Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilka","family":"Rauert\u2010Wunderlich","sequence":"additional","affiliation":[{"name":"Institute of Pathology University of W\u00fcrzburg W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Seifert","sequence":"additional","affiliation":[{"name":"Department of Medical Bioinformatics University Medical Center G\u00f6ttingen G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Kosch","sequence":"additional","affiliation":[{"name":"Peter L. 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