3 distinct groups of lymphoma
1.Germinal center
2.Activated B cell
3.Primary Mediastinal B cell lymphoma (closer to Hodgkin disease)
when activated B cell, the prognosis is worse
somatic mutation may also influence outcome
Hans model CD10 BCL-6 and MUM-1/IRF4 model to determine cell of origin
The Germinal Center B cell lymphoma respond well to R-EPOCH (CD10+, BCL-6+, MUM-1 -negative)
whereas the Activated B-cell lymphoma may be better of with Ibrutinib based treatment
Germinal Center responds better to Revlimid than Activated B cell lymphoma
Addition of Velcade allows to conquer the the resistance due to Activated B Cell Lymphoma
Those c-MYC positivity are the worse...and may need upfront transplant...or a clinical trial
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