Prognostic Analysis of Diffuse Large B-Cell Lymphoma Patients Based on Clinical Characteristics, TP53 Mutation Status, and Number of Co-mutated Genes

We retrospectively analyzed 59 patients newly diagnosed with diffuse large B-cell lymphoma (DLBCL) in our hospital, based on next-generation sequencing mutation analysis and clinical characteristics. One or more mutations were detected in all patients, with a median mutation count of four (range 1–9). The genes with the highest mutation frequencies (> 10%) included TP53 (37.3%), KMT2D (27.1%), CD79B (25.4%), PIM1 (22.0%), TNFAIP3 (18.6%), MYD88 (16.9%), IRF4 (15.3%), B2M (13.6%), TNFRSF14 (11.9%), CREBBP (10.2%), and SOCS1 (10.2%). Statistical analysis revealed that B symptoms, an International Prognostic Index score > 2, and poor treatment efficacy were associated with inferior progression-free survival (PFS) and overall survival (OS). A mutation count greater than four, TP53 mutation, and KMT2D mutation combined with more than four mutations led to poorer OS and PFS, while IRF4 mutation was associated with better OS and a trend towards improved PFS. Therefore, it might be possible to identify high-risk patients in DLBCL through clinical characteristics and genetic mutation profiling, which may allow for personalized treatment leading to improved prognosis.