The Frequency of Double Expresser in Selected Cases of High Grade Diffuse Large B-Cell Lymphomas

Naseem, Maria; Asif, Muhammad; Khadim, Muhammad Tahir; Uddin, Hafeez; Jamal, Shahid; Shoaib, Iman

doi:10.31557/apjcp.2020.21.4.1103

Cited by 5 publications

(5 citation statements)

References 17 publications

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“…This last approach is very controversial since DLBCL constitutes a great number of non-Hodgkin lymphomas, accounting for 30-40% of all B-cell lymphomas in western countries, thus encompassing high financial costs 23 . This is particularly evident if we consider the low frequency of these chromosomal anomalies since, for instance, DH-HGBL has been reported as accounting for around 4% of DLBCL cases 22 .…”

Section: Discussionmentioning

confidence: 99%

Clinical and Pathological Features of Double-Hit and Triple-Hit High-Grade B-Cell Lymphomas: A Retrospective Study from Three Portuguese Tertiary Centers

Almeida¹,

Abrantes²,

Gigliano³

et al. 2022

IJHOSCR

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Background: High-grade B-cell lymphoma (HGBL) with rearrangements of MYC and BCL2 and/or BCL6, called double and triple-hit lymphomas (DTH-HGBL), are lymphoid malignancies with inferior outcomes when treated with standard chemotherapy. The identification of DTH-HGBL cases is challenging, considering their variable clinical, morphologic, and immunohistochemical features. Materials and Methods: Retrospective revision of medical data of patients diagnosed with DTH-HGBL confirmed by FISH, between January 2010 and January 2020, in three Tertiary Portuguese Hospitals (Coimbra Hospital and University Center, Portuguese Oncology Institute – Coimbra and Portuguese Oncology Institute – Porto). Pathological features, morphology, and immunohistochemical profile were evaluated by at least two experienced pathologists in hematopoietic and lymphoid neoplasms. Results: The cohort included 24 patients: 33.3% triple-hit, 58.3%, MYC/BCL2 double-hit and 8.3% MYC/BCL6 double-hit. There was no gender predominance, with a median age of 62.5±14.3y, 33.3% were diagnosed as nodal disease, and 66.7% as extranodal. Morphologic features of DLBCL were present in 50% of cases, morphological features of both DLBCL and Burkitt lymphoma (DLBCL/BL) in 45.8% and 4.2% of blastoid morphology. Immunohistochemical evaluation, regarding the Hans algorithm, revealed a Germinal center (GC)/GC-like subtype in 83.3% of cases and a non-GC/non-GC-like subtype in 16.7%. MYC was positive in 42.9% and the median proliferative index was 80±12.4%. Conclusion: DTH-HGBL has a very broad range of features. We consider that a cost-effective approach would be to perform cytogenetic analysis in DLBCL and DLBCL/BL cases with GC/GC-like subtype. MYC and BCL2 immunohistochemistry can be useful to identify patients who may benefit from more aggressive therapies, but not as tools for case selection for FISH.

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Section: Discussionmentioning

confidence: 99%

Clinical and Pathological Features of Double-Hit and Triple-Hit High-Grade B-Cell Lymphomas: A Retrospective Study from Three Portuguese Tertiary Centers

Almeida¹,

Abrantes²,

Gigliano³

et al. 2022

IJHOSCR

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“…The reported frequency is 1.5-4.3% in previously reported studies [ 14 - 16 ]. However, to date, very limited data are available at the international level regarding cyclin D1 expression in triple-hit lymphoma to label it as quadruple-hit lymphoma [ 6 ]. In this study, the frequency of cyclin D1 expression was studied, and it was found that in double expressors, the frequency of cyclin D1 is 5%.…”

Section: Discussionmentioning

confidence: 99%

“…In Pakistan, exact statistics regarding the incidence of HGBL are unknown, as there is no cancer registry at the national level. According to one study conducted in Pakistan [ 6 ], the frequency of double-expressers is 14%. However, no data are available regarding the frequency of triple expressors in our population.…”

Section: Introductionmentioning

confidence: 99%

“…However, no data are available regarding the frequency of triple expressors in our population. Cyclin D1 expression is known to be expressed by mantle cell lymphoma (MCL), particularly pleomorphic and blastoid variants [ 6 ]. Recently, Cyclin D1 expression has been seen in a few cases of HGBL, but no data are available regarding its expression in our population [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Expression of c-Myc, Bcl2, Bcl6, and Cyclin D1 in High-Grade B-Cell Lymphoma

Ali¹,

Rathore²,

Jahangir³

et al. 2022

Cureus

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“…Nagib et al studied double-expressor DLBCL and found that it was associated with an overall decreased disease-free survival [ 8 ]. Naseem et al studied the frequency and prognosis of double-expressor DLBCL and found that the frequency of c-MYC/BCL-2 co-expression was 14%, with a median survival of 10 months [ 9 ]. Conversely, we found a higher frequency of double-expressor phenotype in our study (35.8%).…”

Section: Discussionmentioning

confidence: 99%

Double-Expressor Phenotype (BCL-2/c-MYC Co-expression) of Diffuse Large B-Cell Lymphoma and Its Clinicopathological Correlation

Hashmi¹,

Iftikhar²,

Nargus³

et al. 2021

Cureus

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Introduction Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease, the spectrum of which is increasing with time. The 2016 World Health Organization (WHO) update on hematopoietic tumors recognized a prognostic subgroup of DLBCL called double-expressor DLBCL. Double-expressor DLBCL is defined by the coexpression of c-MYC and BCL-2 by using immunohistochemical (IHC) studies. To our knowledge, very few studies have looked into the pathological features of this newly defined prognostic category of DLBCL; therefore, in this study we evaluated the frequency of the double-expressor phenotype of DLBCL and its association with other clinicopathological parameters. Methods We conducted a retrospective observational study in the Department of Histopathology, Liaquat National Hospital and Medical College, from November 2017 till December 2020. Pathological and clinical records were retrieved from departmental archives. All cases diagnosed as DLBCL were included in the study. More than 40% c-MYC expression in the presence of more than 50% BCL-2 expression was defined as doubleexpressor DLBCL. Results The mean age of the patients was 52.1±16.9 years. The mean Ki67 index was 73.0±17.0%. A total of 48.6% cases were of germinal center B-cell-like (GCB) subtype, and 59.6% cases were nodal. Double-expressor phenotype was noted in 35.8% of DLBCL cases. A significant association of double-expressor phenotype was noted with age, gender, Ki67 index and subtype of DLBCL. Double-expressor DLBCL had a higher mean age than non-double-expressor DLBCL. Similarly, double-expressor DLBCL had a higher Ki67 index. Moreover, double-expressor phenotype was associated with non-GCB subtype DLBCL. Conclusion We found a high proportion of double-expressor phenotype DLBCL in our population. Moreover, doubleexpressor phenotype DLBCL was associated with female gender, higher age, higher Ki67 and non-GCB subtype. The association of double-expressor DLBCL with a high Ki67 index and non-GCB subtype confers a poor prognostic significance of this variant of DLBCL, requiring more aggressive therapy.

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The Frequency of Double Expresser in Selected Cases of High Grade Diffuse Large B-Cell Lymphomas

Cited by 5 publications

References 17 publications

Clinical and Pathological Features of Double-Hit and Triple-Hit High-Grade B-Cell Lymphomas: A Retrospective Study from Three Portuguese Tertiary Centers

Clinical and Pathological Features of Double-Hit and Triple-Hit High-Grade B-Cell Lymphomas: A Retrospective Study from Three Portuguese Tertiary Centers

Expression of c-Myc, Bcl2, Bcl6, and Cyclin D1 in High-Grade B-Cell Lymphoma

Double-Expressor Phenotype (BCL-2/c-MYC Co-expression) of Diffuse Large B-Cell Lymphoma and Its Clinicopathological Correlation

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