Double‐hit BCL 2/ MYC translocations in a consecutive cohort of patients with large B‐cell lymphoma – a single centre's experience

Concurrent BCL 2 and MYC translocations, so called double hit ( DH ), are a rare finding in large B ‐cell lymphoma ( LBCL ). Based on data from retrospective series, DH has been correlated with aggressive clinical behaviour and poor outcome. We conducted a consecutive study of DH incidence and correlation with pathologic and clinical characteristics, including response to Rituximab‐containing chemotherapy and survival, in an unselected cohort of patients with LBCL . Translocations involving BCL 2 and MYC loci were examined with fluorescent in situ hybridization ( FISH ) in 157 patients with diffuse large B ‐cell lymphoma ( DLBCL ) or B ‐cell lymphoma, unclassifiable, with features intermediate between diffuse large B ‐cell lymphoma and Burkitt lymphoma ( BCLU ). The incidence of DH was 11% in the total cohort, 7% of primary LBCL and 21% of transformed LBCL . DH lymphomas were all GCB immunophenotype and were more often BCLU . No clinical characteristics were correlated with the presence of DH , which also had no impact on overall response rate ( ORR ), relapse rate or overall survival ( OS ). However, sub‐stratification of DH lymphomas by FISH indicated a possible inferior survival related to immunoglobulin MYC translocation partner gene. Screening of patients with BCLU and DLBCL of GCB type for DH BCL 2/ MYC translocation including MYC translocation partner gene may provide important prognostic information.