MYC and BCL2 deregulation in DLBCL and HGBL
| Morphology and immunophenotype . | DLBCL (%) . | HGBL (%) . | |
|---|---|---|---|
| GCB . | ABC . | ||
| MYC protein by IHC | 27 | 35 | 60 |
| Mechanisms | Translocation | BCR and NF-κB signaling | Translocation |
| Incidence of translocation | 21 | 5 | 60 |
| BCL2 protein by IHC | 43 | 63 | 70 |
| Mechanisms | Translocation | BCR and NF-κB signaling; gene amplification | Translocation |
| Incidence of translocation | 25 | 5 | 40 |
| DE-DLBCL | 15 | 23 | NA |
| MYC and BCL2 translocations | 6 (if de novo DLBCL) 21 (if prior FL*) | <1 | 30 |
| MYC and BCL6 translocations | 2† | 2 | |
| Morphology and immunophenotype . | DLBCL (%) . | HGBL (%) . | |
|---|---|---|---|
| GCB . | ABC . | ||
| MYC protein by IHC | 27 | 35 | 60 |
| Mechanisms | Translocation | BCR and NF-κB signaling | Translocation |
| Incidence of translocation | 21 | 5 | 60 |
| BCL2 protein by IHC | 43 | 63 | 70 |
| Mechanisms | Translocation | BCR and NF-κB signaling; gene amplification | Translocation |
| Incidence of translocation | 25 | 5 | 40 |
| DE-DLBCL | 15 | 23 | NA |
| MYC and BCL2 translocations | 6 (if de novo DLBCL) 21 (if prior FL*) | <1 | 30 |
| MYC and BCL6 translocations | 2† | 2 | |
This table presents the incidence of MYC and BCL2 protein expression and their main mechanisms of deregulation by lymphoma subtype. Values are based on 1106 patients who had available data for MYC and BCL2 expression according to cell of origin subtype in 2 independent studies.8,10 In these studies, 529 of 1106 patients had the ABC subtype and 578 of 1106 had the GCB subtype. Of the GCB patients, 15% had DE-DLBCL, 6% would be reclassified as HGBL-DH with MYC and BCL2 translocations, and 2% would be reclassified with MYC and BCL6 translocations.
FL, follicular lymphoma; IHC, immunohistochemistry NA, not applicable.
In total, 21% of patients with DLBCL who have undergone histologic transformation from a previous follicular lymphoma (FL) are estimated to be HGBL-DH from the study by Pedersen et al.77
Most of the GCB DLBCL with MYC and BCL6 translocations are triple hits and would be included in the 6% of patients with HGBL-DL harboring MYC and BCL2 translocations.