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🌱 來自：double-hit in DLBCL

clinical_features_of_double-hit_and_double-expressor_dlbcl

DHL 👊👊

• Patients with DHL frequently present with aggressive clinical features.
• In an analysis by Tomita et al,50 of the 27 patients with DHL, 92% demonstrated an elevated lactate dehydrogenase (LDH) level, 93% had extranodal disease, and 87% demonstrated a high-risk IPI score.
• In a retrospective analysis by the MD Anderson Cancer Center,51 84% of the patients with DHL harbored advanced-stage disease (stage III/IV), 65% were male, and LDH was elevated in 69% of the cases.
• Petrich et al reported similar findings in a multicenter, retrospective analysis of 311 patients with DHL. In their study, 67% of the patients were male, 81% of the patients demonstrated advanced-stage disease, and 76% were noted to have elevated LDH levels.
• DHL is estimated to occur in approximately 5% to 12% of DLBCL cases

DEL 👀

DEL also has a distinct clinical phenotype, as demonstrated by Green et al.43 In their retrospective analysis, patients with DEL had a median age of 71 years, whereas the median age was 62 years for patients without double-hit or double-expressor DLBCL. In addition, patients with DEL were more likely to have a poor performance status, advanced-stage disease, a higher Ki-67 proliferative index, intermediate/high-risk to high-risk IPI scores, multiple extranodal sites of disease, and an inferior complete response rate to R-CHOP chemotherapy.

Compared with DHL, DEL is seen more commonly in clinical practice

In a study by Johnson et al, 18% of the analyzed patients demonstrated dual overexpression of BCL2 and MYC. Similarly, in a study by Hu et al,44 34% of the patients demonstrated these aberrations. Overall, it is estimated that 20% to 30% of patients with DLBCL will have DEL.