TY - JOUR
T1 - Rare transformation to double hit lymphoma in Waldenstrom's macroglobulinemia
AU - Okolo, Onyemaechi N.
AU - Johnson, Ariel C.
AU - Yun, Seongseok
AU - Arnold, Stacy J.
AU - Anwer, Faiz
N1 - Funding Information:
This work was supported by grants P30 CA023074 from the National Cancer Institute, National Institutes of Health, Bethesda, MD, USA and NIH Grant NIHT35 HL07479 (Short-Term Institutional Research Training Grant). The authors have no relevant affiliations or financial involvement with any private organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. No writing assistance was utilized in the production of this manuscript.
Publisher Copyright:
© 2017 2017 Future Medicine Ltd.
PY - 2017/8
Y1 - 2017/8
N2 - Waldenström macroglobulinemia (WM) is a lymphoproliferative lymphoma that is characterized by monoclonal immunoglobulin M (IgM) protein and bone marrow infiltration. Its incidence is rare and rarer still is its ability to transform to a B-cell lymphoma, particularly the aggressive diffuse large B-cell lymphoma, which bodes a poor prognosis. When transformation includes mutations of MYC, BCL-2 and/or BCL-6, it is known as a 'double hit' or 'triple hit' lymphoma respectively. This paper presents a rare case of WM with mutations positive for MYC and BCL2, making it a case of double hit B-cell lymphoplasmacytic lymphoma with plasmatic differentiation without morphological transformation to aggressive histology like DLBCL. The paper also broadens to include discussions on current topics in the classification, diagnosis, possible causes of transformation, and treatment of WM, including transformation to double hit lymphoma. The significance of this case lies in that the presence of double hit lymphoma-like genetic mutations in WM have not been previously described in the literature and potentially such changes are harbinger of extra-nodal presentation, aggressive growth, and possibly poor prognosis, if data from other double-hit lymphoma are extrapolated.
AB - Waldenström macroglobulinemia (WM) is a lymphoproliferative lymphoma that is characterized by monoclonal immunoglobulin M (IgM) protein and bone marrow infiltration. Its incidence is rare and rarer still is its ability to transform to a B-cell lymphoma, particularly the aggressive diffuse large B-cell lymphoma, which bodes a poor prognosis. When transformation includes mutations of MYC, BCL-2 and/or BCL-6, it is known as a 'double hit' or 'triple hit' lymphoma respectively. This paper presents a rare case of WM with mutations positive for MYC and BCL2, making it a case of double hit B-cell lymphoplasmacytic lymphoma with plasmatic differentiation without morphological transformation to aggressive histology like DLBCL. The paper also broadens to include discussions on current topics in the classification, diagnosis, possible causes of transformation, and treatment of WM, including transformation to double hit lymphoma. The significance of this case lies in that the presence of double hit lymphoma-like genetic mutations in WM have not been previously described in the literature and potentially such changes are harbinger of extra-nodal presentation, aggressive growth, and possibly poor prognosis, if data from other double-hit lymphoma are extrapolated.
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U2 - 10.2217/imt-2017-0027
DO - 10.2217/imt-2017-0027
M3 - Article
C2 - 28771100
AN - SCOPUS:85028965059
VL - 9
SP - 709
EP - 714
JO - Immunotherapy
JF - Immunotherapy
SN - 1750-743X
IS - 9
ER -