@Article{096504015X14500972666761,
AUTHOR = {Christine G. Roth, Amanda Gillespie-Twardy, Stanley Marks, Mounzer Agha, Anastasios Raptis, Jing-Zhou Hou, Rafic Farah, Yan Lin, Ying Qian, Liron Pantanowitz, Michael Boyiadzis},
TITLE = {Flow Cytometric Evaluation of Double/Triple Hit Lymphoma},
JOURNAL = {Oncology Research},
VOLUME = {23},
YEAR = {2015},
NUMBER = {3},
PAGES = {137--146},
URL = {http://www.techscience.com/or/v23n3/57562},
ISSN = {1555-3906},
ABSTRACT = {“Double” or “triple” hit lymphomas (D/THL) with recurrent translocations involving <i>MYC</i>/8q24 and 
<i>BCL</i>2/18q21 and/or <i>BCL</i>6/3q27 are characterized by a poor prognosis, but their identification is hampered 
by the clinicopathologic overlap with other disease categories. Cases with circulating blastic-appearing 
cells may initially cause concern for lymphoblastic leukemia a diagnostic dilemma, which has not been 
well studied. There is only limited literature regarding the flow cytometric (FC) D/THL phenotype and its 
clinical correlates. The FC features of 20 D/THL (11 <i>BCL</i>2<sup>+</sup>/<i>MYC</i><sup>+</sup>, 5 <i>BCL</i>6<sup>+</sup>/<i>MYC</i><sup>+</sup>, 4 <i>BCL</i>2<sup>+</sup>/<i>BCL</i>6<sup>+</sup>/<i>MYC</i><sup>+</sup>) 
were evaluated, compared to 20 B-lymphoblastic leukemias (B-LBL), and correlated with overall survival. 
Most (89%, 17/19) D/THL were CD10<sup>+</sup>
, 47% (9/19) lacked surface light chain, and a significant subset 
underexpressed CD45 (47%, 9/19), CD20 (42% 8/19), and/or CD19 (39%, 7/18), which did not vary by 
genetic subgroup. Compared to B-LBL, D/THL less frequently underexpressed CD45 (<i>p</i>=0.0001) and CD20 
(<i>p</i>=0.0004). Lower levels of <i>BCL</i>2 expression were noted in the <i>BCL</i>6<sup>+</sup>/<i>MYC</i><sup>+</sup> and <i>BCL</i>2<sup>+</sup>/<i>BCL</i>6<sup>+</sup>/<i>MYC</i><sup>+</sup>
subgroups versus <i>BCL</i>2<sup>+</sup>/<i>MYC</i><sup>+</sup> cases (<i>p</i>=0.0014). Of the flow cytometric parameters assessed, dim CD45 
expression correlated with inferior survival (<i>p</i>=0.01). Although there is some overlap with B-LBL, D/THL 
demonstrates a characteristic immunophenotype which may have prognostic significance and warrants further investigation.},
DOI = {10.3727/096504015X14500972666761}
}