Follicular lymphoma transformation to dual translocated Burkitt-like lymphoma: improved disease control associated with radiation therapy
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Dual translocated (or “dual hit”) lymphomas are highly aggressive B cell neoplasms associated with an extremely poor prognosis. The optimal treatment for these lymphomas remains undefined. We present two cases of follicular lymphoma with transformation to Burkitt-like lymphoma. In both cases dual translocations involving both the bcl-2 and c-myc loci were present. Each patient underwent intensive induction immunochemotherapy followed by autologous stem cell transplantation and radiation therapy. The first patient received post-transplant mediastinal radiation and developed recurrence in multiple areas outside of the radiation field. The second patient received total body irradiation as part of the conditioning regimen, and is without recurrence 18 months after transplant, and 24 months after diagnosis of the dual translocated lymphoma. We review dual translocation B cell lymphoma in the setting of transformation from follicular lymphoma, and suggest a potential role for total body irradiation in the management of this highly aggressive non-Hodgkin lymphoma.
- Magrath I, Adde M, Shad A, et al. Adults and children with small non-cleaved-cell lymphoma have a similar excellent outcome when treated with the same chemotherapy regimen. J Clin Oncol. 1996;14:925–34.
- Thomas DA, Faderl S, O’Brien S, et al. Chemoimmunotherapy with hyper-CVAD plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia. Cancer. 2006;106:1569–80. CrossRef
- Mills W, Chopra R, McMillan A, Pearce R, Linch DC, Goldstone AH. BEAM chemotherapy and autologous bone marrow transplantation for patients with relapsed or refractory non-Hodgkin’s lymphoma. J Clin Oncol. 1995;13:588–95.
- Zelenetz AD, Hamlin P, Kewalramani T, Yahalom J, Nimer S, Moskowitz CH. Ifosfamide, carboplatin, etoposide (ICE)-based second-line chemotherapy for the management of relapsed and refractory aggressive non-Hodgkin’s lymphoma. Ann Oncol. 2003;14(Suppl 1):i5–10. CrossRef
- Thompson JA, Fisher RI, Leblanc M, et al. Total body irradiation, etoposide, cyclophosphamide, and autologous peripheral blood stem-cell transplantation followed by randomization to therapy with interleukin-2 versus observation for patients with non-Hodgkin lymphoma: results of a phase 3 randomized trial by the Southwest Oncology Group (SWOG 9438). Blood. 2008;111:4048–54. CrossRef
- Blum KA, Lozanski G, Byrd JC. Adult Burkitt leukemia and lymphoma. Blood. 2004;104:3009–20. CrossRef
- Nakamura N, Nakamine H, Tamaru J, et al. The distinction between Burkitt lymphoma and diffuse large B-Cell lymphoma with c-myc rearrangement. Mod Pathol. 2002;15:771–6. CrossRef
- McClure RF, Remstein ED, Macon WR, et al. Adult B-cell lymphomas with Burkitt-like morphology are phenotypically and genotypically heterogeneous with aggressive clinical behavior. Am J Surg Pathol. 2005;29:1652–60. CrossRef
- Swerdlow SH, Campo E, Harris NL, et al. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. Lyon: International Agency for Research on Cancer (IARC); 2008.
- Dave SS, Fu K, Wright GW, et al. Molecular diagnosis of Burkitt’s lymphoma. N Engl J Med. 2006;354:2431–42. CrossRef
- Hummel M, Bentink S, Berger H, et al. A biologic definition of Burkitt’s lymphoma from transcriptional and genomic profiling. N Engl J Med. 2006;354:2419–30. CrossRef
- Al-Tourah AJ, Gill KK, Chhanabhai M, et al. Population-based analysis of incidence and outcome of transformed non-Hodgkin’s lymphoma. J Clin Oncol. 2008;26:5165–9. CrossRef
- Kanungo A, Medeiros LJ, Abruzzo LV, Lin P. Lymphoid neoplasms associated with concurrent t(14;18) and 8q24/c-MYC translocation generally have a poor prognosis. Mod Pathol. 2006;19:25–33. CrossRef
- Le Gouill S, Talmant P, Touzeau C, et al. The clinical presentation and prognosis of diffuse large B-cell lymphoma with t(14;18) and 8q24/c-MYC rearrangement. Haematologica. 2007;92:1335–42. CrossRef
- Macpherson N, Lesack D, Klasa R, et al. Small noncleaved, non-Burkitt’s (Burkitt-Like) lymphoma: cytogenetics predict outcome and reflect clinical presentation. J Clin Oncol. 1999;17:1558–67.
- Niitsu N, Okamoto M, Miura I, Hirano M. Clinical features and prognosis of de novo diffuse large B-cell lymphoma with t(14;18) and 8q24/c-MYC translocations. Leukemia. 2009.
- Voorhees PM, Carder KA, Smith SV, Ayscue LH, Rao KW, Dunphy CH. Follicular lymphoma with a Burkitt translocation–predictor of an aggressive clinical course: a case report and review of the literature. Arch Pathol Lab Med. 2004;128:210–3.
- Hecht JL, Aster JC. Molecular biology of Burkitt’s lymphoma. J Clin Oncol. 2000;18:3707–21.
- Tomita N, Tokunaka M, Nakamura N, et al. Clinicopathological features of lymphoma/leukemia patients carrying both BCL2 and MYC translocations. Haematologica. 2009;94:935–43. CrossRef
- Johnson NA, Savage KJ, Ludkovski O, et al. Lymphomas with concurrent BCL2 and MYC translocations: the critical factors associated with survival. Blood. 2009;114:2273–9.
- Sweetenham JW. Highly aggressive lymphoma in adults. Hematol Oncol Clin N Am. 2008;22:965–78. CrossRef
- Rizzieri DA, Johnson JL, Niedzwiecki D, et al. Intensive chemotherapy with and without cranial radiation for Burkitt leukemia and lymphoma. Cancer. 2004;100:1438–48. CrossRef
- Network NCC. NCCN Clinical Practice Guidelines in Oncology: non-Hodgkin’s lymphomas V.1.2009; (2009).
- Heerema NA, Raimondi SC, Anderson JR, et al. Specific extra chromosomes occur in a modal number dependent pattern in pediatric acute lymphoblastic leukemia. Genes Chromosom Cancer. 2007;46:684–93. CrossRef
- Follicular lymphoma transformation to dual translocated Burkitt-like lymphoma: improved disease control associated with radiation therapy
International Journal of Hematology
Volume 90, Issue 5 , pp 616-622
- Cover Date
- Print ISSN
- Online ISSN
- Springer Japan
- Additional Links
- Burkitt-like lymphoma
- Dual translocated lymphoma
- Double-hit lymphoma
- Autologous hematopoietic stem cell transplantation
- Transformed lymphoma
- Radiation therapy
- Industry Sectors
- Author Affiliations
- 1. Department of Internal Medicine, The Medical College of Wisconsin, Milwaukee, WI, USA
- 2. Department of Pathology, The Medical College of Wisconsin, Milwaukee, WI, USA
- 3. Department of Radiation Oncology, The Medical College of Wisconsin, Milwaukee, WI, USA
- 4. Department of Surgery, The Medical College of Wisconsin, Milwaukee, WI, USA
- 5. Division of Neoplastic Diseases and Related Disorders, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI, 53226, USA