Key Points A subset of DHL patients may be cured, and some patients may benefit from intensive induction. Further investigations into the roles of SCT and novel agents are needed.

BACKGROUND Double-hit lymphomas (DHL) are collectively defined as B cell non-Hodgkin lymphomas harboring rearrangements of MYC as well as BCL2 and/or BCL6. The impact of specific oncogene rearrangements on outcomes of DHL patients treated with immunochemotherapy has not been previously described. METHODS We identified cases in which metaphase karyotyping or fluorescence in situ hybridization for MYC as well as both BCL2 and BCL6 rearrangements were performed. Cohorts were defined by the presence (+) or absence (−) of rearrangements: MYC+/BCL2+/BCL6− (BCL2-DHL), MYC+/BCL2−/BCL6+ (BCL6-DHL) and MYC+/BCL2+/BCL6+ (THL). RESULTS 117 cases were included in this analysis (n=76 BCL2-DHL, n=16 BCL6-DHL, n=25 THL). As compared to patients with BCL2-DHL, those with BCL6-DHL were more likely to be classified as non-germinal center cell of origin, present with extranodal disease and appeared to achieve higher rates of complete response despite receiving intensive induction therapy less frequently. However, BCL6-DHL patients experienced a shorter median overall survival if achieving initial complete response as compared to BCL2-DHL patients. THL patients experienced survival outcomes similar to BCL2-DHL patients. CONCLUSIONS Recognition of the specific oncogene rearrangements in DHL cases may be of prognostic value and potentially guide future therapeutic strategies for patients with this disease.

Pancreatitis in patients treated with brentuximab vedotin: a previously unrecognized serious adverse event Brentuximab vedotin (BV) is a novel anti-CD30 antibody drug conjugate that gained accelerated regulatory approval 1 after studies demonstrating impressive efficacy in relapsed Hodgkin lymphoma and anaplastic large cell lymphoma.2-4 The cytotoxic component is monomethylauristatin E, a potent inhibitor of microtubule assembly. Although abdominal pain has been reported in up to 18% of patients treated with BV, pancreatitis is a previously unidentified serious adverse event (while this report was under review, an additional case of BV-associated pancreatitis was reported in which the patient was successfully retreated 5

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