Unexpected favorable outcome in a patient with high grade B-cell lymphoma with abnormalities of MYC, BCL6 and BCL2 loci

We report a case of HGBCL “triple-hit” lymphoma in a 64-year old female. Cytogenetic and fluorescence in situ hybridization (FISH) studies revealed complex karyotype including rearrangement of MYC to a novel, non-IG partner on chromosome 18, and rearrangement of BCL2, BCL6 and IGH as well as ins(3)(q21q27.3q25.1) among other abnormalities. FISH studies showed five copies of MYC and 3–8 copies of BCL2. Gene expression analysis by RNA sequencing showed that MYC, BCL2 and MECOM genes were overexpressed whereas BCL6 was under-expressed. BCL6 was fused to MBNL1 gene due to complex structural rearrangement. MYC was expressed in >70% of cells and BCL2 was diffusely but highly expressed by immunohistochemistry. No pathogenic mutations were identified by sequencing a 26-gene panel including TP53. The patient has unexpectedly been in complete remission for 12 months after diagnosis after intensive chemotherapy including DA-EPOCH regimen despite having HGBCL. The prognostication of HGBCL patients may further be improved by the sub-categorization of these lymphomas on the basis of more detailed genomic markers than merely the WHO 2016 classification.
Source: Cancer Genetics - Category: Cancer & Oncology Source Type: research

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Source: International Journal of Medical Sciences - Category: Biomedical Science Tags: Int J Med Sci Source Type: research
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Source: NIH OTT Licensing Opportunities - Category: Research Authors: Source Type: research
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Source: Clinical Lymphoma and Myeloma - Category: Cancer & Oncology Authors: Tags: J Exp Clin Cancer Res Source Type: research
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Source: Seminars in Immunopathology - Category: Pathology Source Type: research
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Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized Cancer healthytime Innovation Health Source Type: news
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Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
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Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
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Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
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