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A prognostic signature based on ectopic reactivation of eight tissue-specific genes in Diffuse Large B Cell Lymphoma.

Montaut, E.; Rainville, V.; Betton-Fraisse, P.; Merre, W.; Khedimallah, S.; Govin, J.; Rousseaux, S.; Khochbin, S.; Jardin, F.; Ruminy, P.; Bourova-Flin, E.; Emadali, A.; Carras, S.

2026-04-27 hematology
10.64898/2026.04.23.26351580 medRxiv
Show abstract

Diffuse Large B-cell lymphoma (DLBCL) is the most common aggressive lymphoma in the Western world. First-line immunochemotherapy fails in approximately 30-40% of patients, with refractory and relapse patients presenting a dismal prognosis. Currently, these high-risk patients cannot be accurately identified at diagnosis. Using statistical modeling and machine learning approaches applied to large public DLBCL datasets, we identified a novel predictive signature based on the reactivation of eight normally silent tissue-dependent genes associated with survival. We then developed a multiplex RT-MLPseq based assay, compatible with formalin-fixed paraffin-embedded (FFPE) samples and transferable into routine clinical practice, enabling analysis of expression of these eight genes and validated their prognosis impact in an independent real-life cohort. This signature could be integrated with current prognostic indices and molecular classifications to improve patient stratification and guide treatment selection toward a personalized theragnostic approach, thereby enhancing management of non-responder patients.

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