Follicular lymphoma transformation to dual translocated Burkitt-like lymphoma: improved disease control associated with radiation therapy

  • Stacey M. Parker
  • Horatiu Olteanu
  • Peter VanTuinen
  • Colleen A. Lawton
  • Christopher J. Schultz
  • Kathleen K. Christians
  • Timothy S. Fenske
Case Report


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.


Burkitt-like lymphoma Dual translocated lymphoma Double-hit lymphoma Autologous hematopoietic stem cell transplantation Transformed lymphoma Radiation therapy 


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Copyright information

© The Japanese Society of Hematology 2009

Authors and Affiliations

  • Stacey M. Parker
    • 1
  • Horatiu Olteanu
    • 2
  • Peter VanTuinen
    • 2
  • Colleen A. Lawton
    • 3
  • Christopher J. Schultz
    • 3
  • Kathleen K. Christians
    • 4
  • Timothy S. Fenske
    • 5
  1. 1.Department of Internal MedicineThe Medical College of WisconsinMilwaukeeUSA
  2. 2.Department of PathologyThe Medical College of WisconsinMilwaukeeUSA
  3. 3.Department of Radiation OncologyThe Medical College of WisconsinMilwaukeeUSA
  4. 4.Department of SurgeryThe Medical College of WisconsinMilwaukeeUSA
  5. 5.Division of Neoplastic Diseases and Related DisordersMedical College of WisconsinMilwaukeeUSA

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