Double hit lymphoma: the MD Anderson Cancer Center clinical experience. (18th June 2014)

• Record Type: Journal Article
• Authors: Oki, Yasuhiro; Noorani, Mansoor; Lin, Pei; Davis, Richard E.; Neelapu, Sattva S.; Ma, Long; Ahmed, Mohamed; Rodriguez, Maria Alma; Hagemeister, Fredrick B.; Fowler, Nathan; Wang, Michael; Fanale, Michelle A.; Nastoupil, Loretta; Samaniego, Felipe; Lee, Hun J.; Dabaja, Bouthaina S.; Pinnix, Chelsea C.; Medeiros, Leonard J.; Nieto, Yago; Khouri, Issa; Kwak, Larry W.; Turturro, Francesco; Romaguera, Jorge E.; Fayad, Luis E.; Westin, Jason R.
• Is Part Of: British journal of haematology. Volume 166:Number 6(2014:Sep.)
• Page Start: 891
• Page End: 901
• Publication Date: 2014-06-18
• Subjects: Hematology -- Periodicals; Blood -- Diseases -- Periodicals; 616.15
• DOI: 10.1111/bjh.12982
• Languages: English
• ISSNs: 0007-1048

Abstract

<abstract abstract-type="main" id="bjh12982-abs-0001"> <title>Summary</title> <p>We report our experience with 129 cases of double hit lymphoma (DHL), defined as B‐cell lymphoma with translocations and/or extra signals involving <italic>MYC</italic> plus <italic>BCL2</italic> and/or <italic>BCL6</italic>. All cases were reviewed for histopathological classification. Median age was 62 years (range, 18–85), 84% of patients had advanced‐stage disease, and 87% had an International Prognostic Index score ≥2. Fourteen patients (11%) had a history of low‐grade follicular lymphoma. <italic>MYC</italic> translocation was present in 81%, and extra signals of <italic>MYC</italic> in 25% of patients. <italic>IGH‐BCL2</italic> translocation was present in 84% and extra signals of <italic>BCL2</italic> in 12% of patients. Two‐year event‐free survival (EFS) rates in all patients and patients who received R‐CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone), R‐EPOCH (rituximab, etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin), and R‐HyperCVAD/MA (rituximab, hyperfractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone, alternating with cytarabine plus methotrexate) were 33%, 25%, 67% and 32%, respectively. In patients achieving complete response with initial therapy (<italic>n</italic> = 71), 2‐year EFS rates in patients who did (<italic>n</italic> = 23) or did not (<italic>n</italic> = 48) receive frontline stem cell transplantation were 68% and 53%, respectively (<italic>P</italic> = 0·155). The cumulative incidence of central nervous system involvement was 13% at 3 years. Multivariate analysis identified performance status ≥2 and bone marrow involvement as independent adverse prognostic factors for EFS and OS. Further research is needed to identify predictive and/or targetable biological markers and novel therapeutic approaches for DHL patients.</p> </abstract>