Advertisement

How I treat double-hit lymphoma

Jonathan W. Friedberg

Article Figures & Data

Figures

  • Figure 1.

    New WHO classification of lymphoma. Regardless of morphology, if myc and bcl-2 rearrangements are present, they are now categorized as high-grade B-cell lymphoma with myc and bcl-2 and/or bcl-6 rearrangements. HGBL, high-grade B-cell lymphoma; NOS, not otherwise specified. Adapted from Swerdlow et al.21

  • Figure 2.

    Myc and DLBCL. Approximately one-third of DLBCLs are positive for myc and bcl-2 by immunohistochemistry (double expressor); most of these occur in ABC DLBCL. The new WHO category of high-grade B-cell lymphoma with myc and bcl-2 and/or bcl-6 rearrangements (double hit) usually, but not always, falls in the double-expressor group, but in the GCB subtype. Additionally, morphology of this group may include Burkitt-like lymphoma.

Tables

  • Table 1.

    Terminology of myc-associated disease

    Double-hitHigh-grade lymphoma with rearrangements of myc and bcl-2 or myc and bcl-6; must be diagnosed with FISH or more advanced genomic techniques.
    Triple-hitHigh-grade lymphoma with rearrangements of myc and bcl-2 and bcl-6; must be diagnosed with FISH or more advanced genomic techniques.
    Double-expressorProtein expression of MYC and BCL-2 and/or BCL-6; measured by using an immunohistochemistry cutoff for the percentage of positive cells.