Dr. Smith Discusses Double-Hit and Triple-Hit Lymphoma

Sonali M. Smith, MD, Elwood V. Jensen Professor in Medicine, director, Lymphoma Program, University of Chicago Medicine, discusses double-hit and triple-hit lymphoma.

The classification for lymphoma has changed and evolved over the years, Smith says. Certain lymphomas have very aggressive morphologic features, as well as biologic features, that can change the prognosis of a patient if identified. The discovery of these features signaled the need for a change in the classification of lymphoma, Smith says.

The MYC rearrangement, which is classically seen in Burkitt lymphoma, is now known to occur in 10% to 15% of patients with unselected diffuse large B-cell lymphoma. The WHO created a new category after it was discovered that these patients have a poor outcome after R-CHOP therapy. This category is called double-hit or triple-hit high-grade B-cell lymphoma based on the presence of an aggressive B-cell morphology plus a MYC rearrangement, and a BCL2 or BCL6 rearrangement.