Dr. Smith Discusses the Diagnosis of Double-Hit Lymphoma

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.