title: [Double-Hit Follicular Lymphoma with BCL2 and MYC Translocations].
abstract: Double-hit lymphomas are rare tumors that are defined by a chromosomal breakpoint affecting the MYC/8q24 locus in combination with another recurrent breakpoint, mainly a t(14; 18)(q32;q21)involving BCL2. We report a case of a 38-yearold woman with a 2-month history of abdominaldistention. 18F-FDG PET showed multiple positive systemic lymph nodes, positive peritoneum, and multiple positive intra-abdominal masses. Histopathology results of the cervical lymph node were compatible with double-hit follicular lymphoma(Grade 3A)because fluorescence in situ hybridization(FISH)demonstrated both MYC rearrangement and BCL2 gene fusion. She was initially started on R-CHOP(rituximab and doxorubicin, vincristine, cyclophosphamide, and prednisolone), but after one course the regimen was changed to dose-adjusted EPOCH-R(rituximab and doxorubicin, etoposide, vincristine, cyclophosphamide, and prednisolone). However, she showed no response to this chemotherapy regimen or haploidentical stem cell transplantation. The treatment strategy included salvage chemothera- py. An autologous and/or allogeneic hematopoietic transplantation is important for non-responders to DA-EPOCH-R.
authors.affiliation: Dept. of Hematology, Osaka City General Hospital.
authors.forename: Mirei
authors.initials: M
authors.lastname: Horiuchi
authors.forename: Hoyuri
authors.initials: H
authors.lastname: Fuseya
authors.forename: Minako
authors.initials: M
authors.lastname: Tsutsumi
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Kiyoyuki
authors.initials: K
authors.lastname: Hagihara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kanashima
authors.forename: Takafumi
authors.initials: T
authors.lastname: Nakao
authors.forename: Yuko
authors.initials: Y
authors.lastname: Fukushima
authors.forename: Takeshi
authors.initials: T
authors.lastname: Inoue
authors.forename: Takahisa
authors.initials: T
authors.lastname: Yamane
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008224:Lymphoma, Follicular / Q000188:drug therapy* / Q000235:genetics; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000235:genetics*; D016271:Proto-Oncogene Proteins c-myc / Q000235:genetics*; D014178:Translocation, Genetic
chemical_list: C000595707:BCL2 protein, human; C489427:MYC protein, human; D019253:Proto-Oncogene Proteins c-bcl-2; D016271:Proto-Oncogene Proteins c-myc