“双打击”B细胞淋巴瘤(double-hit lymphoma,DHL)是一种近年来被确认的B细胞淋巴瘤分子分型,主要涉及MYC和Bcl-2基因的重排。荧光原位杂交(fluorescence in situ hybridization,FISH)是诊断DHL的金标准,而通过免疫组化检测MYC和Bcl-2蛋白的表达仍存在一定的争议。大量的回顾性分析表明,DHL是一种预后很差的独特类型,主要发生于弥漫大B细胞淋巴瘤或灰区淋巴瘤,且目前缺乏标准的治疗方案。无论是利妥昔单抗的联合抑或干细胞移植似乎均不能显著逆转DHL的不良预后,其治疗的改善应依赖于探索特异性的分子靶向药物。
Abstract
Recently
double-hit lymphoma (DHL) was clarified to be a molecular category of B-cell lymphoma
which was mainly related to MYC and Bcl-2 genes translocation. Fluorescence in situ hybridization (FISH) is the gold standard of diagnosis and it is controversial to detect the expression of MYC and Bcl-2 protein by immunohistochemistry. DHL
which was found to be aggressive according to many retrospective analyses
mainly develops in patients with diffuse large B-cell lymphoma and grey zone lymphoma. Both rituximab combination and transplant consolidation were not able to significantly overcome the poor prognosis of DHL. Novel and specific molecular targeted agents need to be explored and investigated in order to improve the treatment outcome.