Double/Triple Hit Lymphoma

High Grade Aggressive B Cell Lymphomas (Double & Triple-Hit Lymphomas)
The WHO Classification in 2017 classified lymphomas with concurrent rearrangement of MYC, BCL2, and/or BCL6 as high-grade B cell lymphomas with an aggressive clinical course.
Double-hit and triple-hit lymphomas are difficult to classify morphologically without aid of FISH.
The diagnosis is based on interphase FISH for MYC, BCL2, and BCL6.

Sample Requirements:

Peripheral Blood or Bone Marrow
- 2-5mL in a sodium heparin (green top) tube. 5 mL in a EDTA (purple top) will be accepted for FISH testing but is not preferred.
- Minimum: 1 mL
Storage: Room temperature if being shipped within 24 hours. Refrigerate if shipping will be delayed.
Stability: Sample is optimum if received within 48 hours
Transportation: Room temperature (do not freeze or fix)

Abnormal BCL2 FISH

Test ID	Test Name	Disease	Technology
90	Triple Hit Lymphoma FISH Panel (includes Tests 91-93)	Aggressive Lymphoma	FISH
91	18q21.3 BCL2	Aggressive Lymphoma	FISH
92	3q27 BCL6	Aggressive Lymphoma	FISH
93	8q24.21 MYC	Aggressive Lymphoma	FISH

Test ID	Test Name	Disease	Technology
151	Chromosome Analysis, Bone Marrow or Peripheral Blood	Hematopoeitic Malignancies	Cytogenetics

FISH probes for High Grade B Cell Lymphomas (Double or Triple-Hit)

Selected References:

Swerdlow, S. H., Campo, E., Pileri, S. A., Harris, N. L., Stein, H., Siebert, R., ... & Jaffe, E. S. (2016). The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood, The Journal of the American Society of Hematology, 127(20), 2375-2390.
Bacher, U., Haferlach, T., Alpermann, T., Kern, W., Schnittger, S., & Haferlach, C. (2011). Several lymphoma‐specific genetic events in parallel can be found in mature B‐cell neoplasms. Genes, Chromosomes and Cancer, 50(1), 43-50.