FISH: AGGRESSIVE LYMPHOMA PANEL
This panel differentiates double-hit or triple-hit lymphomas (which have MYC rearrangements together with BCL2 and/or BCL6 rearrangements) from Burkitt lymphoma or diffuse large B-cell lymphoma. Double-hit and triple-hit lymphomas are difficult to classify morphologically without aid of cytogenetics/FISH or IHC, and are associated with an aggressive course. Clients may choose to add MYC/IgH/CEN8 t(8:14) and/or BCL2 breakapart testing to their initial test order. MYC/IgH/CEN8 will confirm heavy chain rearrangement when MYC is rearranged. BCL2 breakapart allows inclusion of BCL2 rearrangements other than IgH/BCL2 t(14;18). Ideally this panel should be ordered in all B-cell lymphomas with features intermediate between Diffuse large B-cell lymphoma (DLBCL) & Burkitt lymphoma (BL); any lymphoma with Ki-67 proliferation index 90%; any DLBCL which has recurred & is refractory to therapy. Testing is indicated when B-cell lymphoma patients experience transformation, relapse or refractory disease.
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