Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous hematological malignancy, accounting for approximately 30% of all lymphomas, and is associated with diverse clinical outcomes. The onset of DLBCL typically occurs in the sixth decade of life, with a higher incidence in males. The morphological, clinical, and biological diversity of DLBCL underscores the presence of multiple subtypes, each exhibiting distinct behavior.

The objective of this study is to assess the demographic characteristics and clinical outcomes of DLBCL patients, as well as to evaluate the prevalence and prognostic significance of MYC and BCL2 co-expression on survival.

A retrospective study was performed on 51 patients with a confirmed diagnosis of DLBCL. We conducted an analysis of the demographic data and molecular characteristics of patients diagnosed with diffuse large B-cell lymphoma who underwent R-CHOP therapy and were monitored between 2016 and 2022. The MYC and BCL-2 expression levels in the patients were analyzed using immunohistochemical methods, while their genetic rearrangements were assessed by fluorescence in situ hybridization (FISH) at Çukurova University Faculty of Medicine Hospital.

The median age at diagnosis was approximately 55 years, with a predominance of female patients. The cervical region was the most frequent nodal site of the primary tumor, whereas the stomach represented the most common extranodal site. The majority of patients were diagnosed at Stage III. MYC/BCL2 protein co-expression was identified in approximately 27% of DLBCL cases and was significantly associated with poorer overall survival and progression-free survival compared to cases lacking co-expression. MYC/BCL2 double-hit cases were detected in approximately 2.5% of the total cases.

MYC and BCL2 co-expression is a significant prognostic marker, correlating with worse survival. Early identification of MYC/BCL2 co-expression could guide personalized treatment strategies for high-risk patients.