TY - JOUR
T1 - Challenges and Opportunities for High-grade B-Cell Lymphoma with MYC and BCL2 and/or BCL6 Rearrangement (Double-hit Lymphoma)
AU - Zeng, Dongfeng
AU - Desai, Aakash
AU - Yan, Fangfang
AU - Gong, Tiejun
AU - Ye, Haige
AU - Ahmed, Makhdum
AU - Nomie, Krystle
AU - Romaguera, Jorge
AU - Champlin, Richard
AU - Li, Shaoying
AU - Wang, Michael
N1 - Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - The most common subtype of non-Hodgkin lymphoma, diffuse large B-cell lymphoma, is cured in approximately two thirds of patients after initial therapy. The remaining one-third of patients who suffer relapse or become refractory have very poor survival outcomes despite salvage chemotherapy with or without stem cell transplantation. A considerable proportion of relapsed or refractory large B cells belong to the WHO subtype known as high-grade B-cell lymphoma with rearrangement of MYC and BCL2 and/or BCL6, also known as double-hit lymphoma (DHL). Most DHL patients present with Ann Arbor's stage III/IV, a comparatively higher rate of extranodal involvement including bone marrow and central nervous system infiltration, high levels of lactate dehydrogenase, and an elevated Ki67 expression in the tumor cells. Newer therapeutic approaches, including targeted therapy against BCL2, MYC, or other associated pathways, are needed. In addition, recent therapies that harness the immune system, such as checkpoint inhibitors and chimeric antigen receptor T-cell therapy, are changing the paradigm of treatment for non-Hodgkin lymphoma and could impact the outcome of DHL.
AB - The most common subtype of non-Hodgkin lymphoma, diffuse large B-cell lymphoma, is cured in approximately two thirds of patients after initial therapy. The remaining one-third of patients who suffer relapse or become refractory have very poor survival outcomes despite salvage chemotherapy with or without stem cell transplantation. A considerable proportion of relapsed or refractory large B cells belong to the WHO subtype known as high-grade B-cell lymphoma with rearrangement of MYC and BCL2 and/or BCL6, also known as double-hit lymphoma (DHL). Most DHL patients present with Ann Arbor's stage III/IV, a comparatively higher rate of extranodal involvement including bone marrow and central nervous system infiltration, high levels of lactate dehydrogenase, and an elevated Ki67 expression in the tumor cells. Newer therapeutic approaches, including targeted therapy against BCL2, MYC, or other associated pathways, are needed. In addition, recent therapies that harness the immune system, such as checkpoint inhibitors and chimeric antigen receptor T-cell therapy, are changing the paradigm of treatment for non-Hodgkin lymphoma and could impact the outcome of DHL.
KW - BCL2
KW - BCL6
KW - MYC
KW - diffuse large B-cell lymphoma (DLBCL)
KW - double-hit lymphoma (DHL)
KW - high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangement
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U2 - 10.1097/COC.0000000000000427
DO - 10.1097/COC.0000000000000427
M3 - Review article
C2 - 29419530
AN - SCOPUS:85046743210
SN - 0277-3732
VL - 42
SP - 304
EP - 316
JO - American Journal of Clinical Oncology: Cancer Clinical Trials
JF - American Journal of Clinical Oncology: Cancer Clinical Trials
IS - 3
ER -