Small Noncleaved, Non-Burkitt's (Burkitt-Like) Lymphoma: Cytogenetics Predict Outcome and Reflect Clinical Presentation

Macpherson, Nicol; Lesack, David; Klasa, Richard; Horsman, Doug; Connors, Joseph M.; Barnett, Michael J.; Gascoyne, Randy D.

doi:10.1200/jco.1999.17.5.1558

Cited by 165 publications

(124 citation statements)

References 27 publications

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“…The largest study published to date included 12 cases, six cases of t(14;18) with t(8;14), and six cases of t(14;18) with t(8;22). 12 These patients presented with advanced disease and had a poor prognosis, and six cases had a history of follicular lymphoma. Thangavelu et al 13 reported six cases with t(14;18) and 8q24 translocation: three that had t(8;14), and three that had t(8;22).…”

Section: Discussionmentioning

confidence: 99%

Lymphoid neoplasms associated with concurrent t(14;18) and 8q24/c-MYC translocation generally have a poor prognosis

et al. 2006

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We identified 14 B-cell neoplasms with concurrent t(14;18) and chromosome 8q24 or c-MYC translocations shown by conventional cytogenetics or fluorescence in situ hybridization analysis. All cases assessed by conventional cytogenetics had a complex karyotype. There were 10 men and four women, with a median age of 55 years (range, 29-72). None of these patients had a history of follicular lymphoma. The biopsy specimens were obtained from bone marrow, lymph node, and extranodal sites. Morphologically, nine neoplasms had features of Burkitt or atypical Burkitt lymphoma/leukemia and three were diffuse large B-cell lymphoma with high-grade cytologic features. The remaining two cases were plasmablastic myeloma and low-grade B-cell lymphoma, respectively. All cases expressed BCL-2. The proliferation index assessed by using Ki-67 (MIB1) was 5% in the low-grade B-cell lymphoma, 80% in the plasmablastic myeloma, 90-95% in three cases of diffuse large B-cell lymphoma, and ranged from 90 to 499% in most Burkitt and atypical Burkitt neoplasms. The patient with low-grade B-cell lymphoma was treated with rituximab. All other patients received intensive combination chemotherapy. Two of these patients underwent bone marrow transplantation, and one patient received radiation therapy in addition to transplantation. The median follow-up period was 9 months (range, 3-81). In all, 10 patients died with a median survival of 9 months (range, 3-81). We conclude that most B-cell lymphomas with concurrent t(14;18) and 8q24/c-MYC translocations fall within the morphologic spectrum of diffuse large B-cell and Burkitt lymphoma. These neoplasms are high-grade and are associated with a poor prognosis. However, this combination of molecular abnormalities can also rarely occur in other neoplasms, such as the cases of low-grade B-cell lymphoma and plasmablastic myeloma in this study.

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Section: Discussionmentioning

confidence: 99%

Lymphoid neoplasms associated with concurrent t(14;18) and 8q24/c-MYC translocation generally have a poor prognosis

et al. 2006

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“…28,29 The presence of an additional translocation as found in other types of B-NHL (for example, involving BCL2, BCL6 and/or CCND1) or a complex karyotype with multiple gains and/or losses would rather represent another type of B-NHL or a secondary transformed lymphoma. 30 This is supported by the publication of the MMML where array based comparative genomic hybridization (arrayCGH) was used to study genomic copy number imbalances in addition to fluorescent in situ hybridization (FISH) analysis for MYC, BCL2 and BCL6 translocations. In contrast to molecular BL, non-molecular BL were characterized by a less frequent IG-MYC translocation and by more additional genomic aberrations.…”

Section: Role Of Genetics In the Diagnosis Of Blmentioning

confidence: 96%

“…Various authors have already suggested that such DH BL cases should be considered a separate entity from 'true' BL. 30,54,55 When comparing the 44 BL IG-MYC DH cases with the core subset, they appeared to be two separate entities. DH BL patients were much older (mean 51 years, Po0.0001, Figure 2), very much similar to the other B-NHL group.…”

Section: Bl With a Non-ig-myc Translocation (Bl Non-ig-myc) Is A Rarementioning

confidence: 99%

Translocations involving 8q24 in Burkitt lymphoma and other malignant lymphomas: a historical review of cytogenetics in the light of todays knowledge

et al. 2008

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“…[4][5][6][7][8][9][10][11][12][13][14] Numerous case series of MYC/BCL2 double-hit lymphoma are reported in the literature. [15][16][17][18][19][20][21][22][23][24] MYC/ BCL2 DHLs represent B10% of all lymphomas that otherwise resemble diffuse large B-cell lymphoma (DLBCL). 10 Although different studies have focused on different aspects or details of double-hit lymphoma, all studies suggest that patients with these lymphomas commonly have an aggressive clinical course characterized by advanced stage disease, extranodal involvement, and high serum lactate dehydrogenase levels.…”

mentioning

confidence: 99%

“…15,20,22,23 To our knowledge, however, little is known about atypical DHL and there is no large study in the literature that has focused on atypical MYC/BCL2 double-hit lymphoma. In this study, we assess the clinicopathologic, immunophenotypic, and cytogenetic features of a large group of patients with atypical double-hit lymphoma, and compare this patient group to a group of patients who had typical double-hit lymphoma as well as a group of patients who had DLBCL not associated with either MYC or t(14;18)(q32;q21)/ IGH@BCL2.…”

mentioning

confidence: 99%

B-cell lymphomas with concurrent MYC and BCL2 abnormalities other than translocations behave similarly to MYC/BCL2 double-hit lymphomas

Seegmiller

Lin

et al. 2015

Modern Pathology

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Large B-cell lymphomas with IGH@BCL2 and MYC rearrangement, known as double-hit lymphoma (DHL), are clinically aggressive neoplasms with a poor prognosis. Some large B-cell lymphomas have concurrent abnormalities of MYC and BCL2 other than coexistent translocations. Little is known about patients with these lymphomas designated here as atypical DHL. We studied 40 patients of atypical DHL including 21 men and 19 women, with a median age of 60 years. Nine (23%) patients had a history of B-cell non-Hodgkin lymphoma. There were 30 diffuse large B-cell lymphoma (DLBCL), 7 B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and Burkitt lymphoma, and 3 DLBCL with coexistent follicular lymphoma. CD10, BCL2, and MYC were expressed in 28/39 (72%), 33/35 (94%), and 14/20 (70%) cases, respectively. Patients were treated with standard (n ¼ 14) or more aggressive chemotherapy regimens (n ¼ 17). We compared the atypical DHL group with 76 patients with DHLand 35 patients with DLBCL lacking MYC and BCL2 abnormalities. The clinicopathologic features and therapies were similar between patients with atypical and typical DHL. The overall survival of patients with atypical double-hit lymphoma was similar to that of patients with double-hit lymphoma (P ¼ 0.47) and significantly worse than that of patients with DLBCL with normal MYC and BCL2 (P ¼ 0.02). There were some minor differences. Cases of atypical double-hit lymphoma more often have DLBCL morphology (Po0.01), less frequently expressed CD10 (Po0.01), and patients less often had an elevated serum lactate dehydrogenase level (P ¼ 0.01). In aggregate, these results support expanding the category of MYC/ BCL2 DHL to include large B-cell lymphomas with coexistent MYC and BCL2 abnormalities other than concurrent translocations.

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Small Noncleaved, Non-Burkitt's (Burkitt-Like) Lymphoma: Cytogenetics Predict Outcome and Reflect Clinical Presentation

Cited by 165 publications

References 27 publications

Lymphoid neoplasms associated with concurrent t(14;18) and 8q24/c-MYC translocation generally have a poor prognosis

Lymphoid neoplasms associated with concurrent t(14;18) and 8q24/c-MYC translocation generally have a poor prognosis

Translocations involving 8q24 in Burkitt lymphoma and other malignant lymphomas: a historical review of cytogenetics in the light of todays knowledge

B-cell lymphomas with concurrent MYC and BCL2 abnormalities other than translocations behave similarly to MYC/BCL2 double-hit lymphomas

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