滤泡细胞性淋巴瘤转化为c-MYC重排的“双击”或“三击”B细胞淋巴瘤3例及文献复习

Transformation of follicular lymphoma to "double-hit" or "triple-hit" lymphoma with c-MYC gene rearrangement: A report of three cases

    摘要
  • 摘要:
      目的   本文旨在对“双击”B细胞淋巴瘤（double-hit B-cell lymphoma，DHL）和“三击”B细胞淋巴瘤（triple-hit B-cell lymphoma，THL）的诊断及治疗分析，以期提高对该类淋巴瘤的认识，为其诊治提供临床经验。
      方法   对2011年1月至2012年12月本院收治的3例滤泡细胞性淋巴瘤（follicular lymphoma，FL）转化的“双击”或“三击”B细胞淋巴瘤病例进行分析，3例患者均经免疫组织化学、荧光染色体原位杂交（fluorescence in situ hybridization，FISH）检测诊断明确。
      结果   1例“三击”患者3个月后死亡，2例经R-CHOP，R-ESHAP等方案化疗仍未达到完全缓解。
      结论   “双击”淋巴恶性程度高，多伴有中枢神经系统、骨髓等髓外病变，病程呈侵袭性，部分病例由滤泡细胞淋巴瘤转化而来，对化疗不敏感，患者预后差，FISH检测是诊断该病的重要手段，目前尚无标准治疗方案。

     

    Abstract:
      Objective   To analyze the diagnosis and therapy for double-hit lymphoma (DHL) and triple-hit lymphoma (THL).
      Methods   This study involves three patients with follicular lymphoma (FL) that transformed into DHL or THL. These patients were admitted to our hospital between January 2011 and December 2012. All patients were diagnosed by immunohistochemistry and fluorescence in situ hybridization (FISH).
      Results   One FL patient transformed into THL and died after 3 months. The other two FL patients who transformed into DHL and who received R-CHOP and R-ESHAP regimens still failed to achieve complete remission.
      Conclusions   DHL is a rare type of lymphoma that usually involves the bone marrow and central nervous system. This condition is highly resistant to intensive chemotherapy. Part of the DHL cases result from FL. FISH is important for diagnosis. However, a standard treatment for this type of lymphoma remains lacking.

     

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