title: Successful treatment of both double minute of C-MYC and BCL-2 rearrangement containing large B-cell lymphoma with subsequent unfortunate development of therapy-related acute myeloid leukemia with t(3;3)(q26.2;q21).
abstract: Double minute chromosomes (DMs), although relatively frequently encountered in solid tumors, are rare in hematologic neoplasms such as acute myeloid leukemia (AML), and even rarer in lymphoid neoplasms. t(3;3)(q26.2;q21) is a very rare genetic alteration observed in myeloid neoplasm. Herein we report an interesting and unique case of concomitant C-MYC DMs and t(14;18)-containing large B-cell lymphoma, which was successfully treated with R-hyper-CVAD; unfortunately, the patient has developed a therapy-related AML (t-AML) 2 years since the start of his lymphoma treatment. His t-AML contains both t(3;3)(q26.2;q21) and monosomy 7, and the patient died of AML 10 months after the initial diagnosis of t-AML despite clinical remission. To the best of our knowledge, this is the first reported case of C-MYC DM-containing de novo large B-cell lymphoma, which was successfully treated with complete remission, but unfortunately died of t-AML harboring t(3;3)(q21;q26).
authors: Department of Pathology, University of California San Diego Health System, La Jolla, CA 92093-0960, United States.
authors: John C
authors: JC
authors: Nguyen
authors: Department of Pathology, University of California San Diego Health System, La Jolla, CA 92093-0960, United States.
authors: Melanie J
authors: MJ
authors: Kubik
authors: Department of Pathology, University of California San Diego Health System, La Jolla, CA 92093-0960, United States.
authors: H Elizabeth
authors: HE
authors: Broome
authors: Division of Hematology, Department of Medicine, University of California San Diego Health System, La Jolla, CA 92093-0960, United States.
authors: Peter T
authors: PT
authors: Curtin
authors: Department of Pathology, University of California San Diego Health System, La Jolla, CA 92093-0960, United States.
authors: Marie L
authors: ML
authors: Dell'Aquila
authors: Department of Pathology, University of California San Diego Health System, La Jolla, CA 92093-0960, United States. Electronic address: huw003@ucsd.edu.
authors: Huan-You
authors: HY
authors: Wang
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D002893:Chromosomes, Human, Pair 3; D017809:Fatal Outcome; D005434:Flow Cytometry; D019254:Genes, bcl-2; D016259:Genes, myc; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000139:chemically induced* / Q000235:genetics*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D016609:Neoplasms, Second Primary / Q000139:chemically induced* / Q000235:genetics*; D014178:Translocation, Genetic
keywords: C-MYC; Double minute; Large B-cell lymphoma; Therapy-related acute myeloid leukemia; t(3 ;3)(q26.2 ;q21)