Dr. Smith Discusses the Diagnosis of Double-Hit Lymphoma

Sonali M. Smith, MD
Published: Friday, Aug 17, 2018



Sonali M. Smith, MD, Elwood V. Jensen Professor in Medicine, director, Lymphoma Program, University of Chicago Medicine, discusses the diagnosis of double-hit lymphoma.

The presence of double-hit lymphoma is relatively uncommon, Smith says, with an incidence of about 5% to 7% in all unselected cases. This is a lot of unselected patients to test by multiple fluorescence in-situ hybridization (FISH) probes to identify a very few number of double-hit cases with a very poor prognosis.

There are different approaches to screening that limit the number of patients who need FISH testing, says Smith. Double-hit lymphoma primarily occurs in patients who have germinal center diffuse large B-cell lymphoma, so some have suggested using the cell-of-origin model to decide which patients need further FISH testing. Another approach is identifying a dual expression of MYC and BCL-2. Smith says that currently, there is no information on which of those will be most cost effective or rational.


Sonali M. Smith, MD, Elwood V. Jensen Professor in Medicine, director, Lymphoma Program, University of Chicago Medicine, discusses the diagnosis of double-hit lymphoma.

The presence of double-hit lymphoma is relatively uncommon, Smith says, with an incidence of about 5% to 7% in all unselected cases. This is a lot of unselected patients to test by multiple fluorescence in-situ hybridization (FISH) probes to identify a very few number of double-hit cases with a very poor prognosis.

There are different approaches to screening that limit the number of patients who need FISH testing, says Smith. Double-hit lymphoma primarily occurs in patients who have germinal center diffuse large B-cell lymphoma, so some have suggested using the cell-of-origin model to decide which patients need further FISH testing. Another approach is identifying a dual expression of MYC and BCL-2. Smith says that currently, there is no information on which of those will be most cost effective or rational.



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