Double-hit (MYC + BCL2 and/or BCL6 rearrangements)

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`BIO-DOUBLE-HIT`
Type	Biomarker
Aliases	Double-hit (MYC + BCL2/BCL6 rearrangements)Double-hit lymphoma rearrangements
Status	reviewed 2026-04-25 \| pending_clinical_signoff
Diseases	None declared
Sources	`SRC-NCCN-BCELL-2025`

Biomarker Facts

Biomarker type	gene_fusion
Measurement	MethodFISH break-apart probes for MYC, BCL2, BCL6 on FFPE biopsy Unitscategorical (positive \| negative)
Related biomarkers	`BIO-MYC-REARRANGEMENT` `BIO-BCL2-REARRANGEMENT` `BIO-BCL6-REARRANGEMENT`

Notes

Defining feature of HGBL-DH/THL. MYC + BCL2 most common. MYC + BCL6 less common. Triple-hit (all three) rarest, worst prognosis. MUST test on every newly-diagnosed DLBCL — missed identification leads to under-treatment with R-CHOP.

Used By

Actionability

BMA-MYC-REARRANGEMENT-HGBL-DH - HGBL with MYC + BCL2 (and/or BCL6) rearrangements ('double-hit' / 'triple-hit') has aggre...

Biomarker

BIO-BCL2-EXPRESSION-IHC - BCL2 expression by IHC
BIO-BCL2-REARRANGEMENT - BCL2 rearrangement (t(14;18) IGH/BCL2 by FISH break-apart)
BIO-BCL6-REARRANGEMENT - BCL6 rearrangement (3q27) by FISH break-apart

Indications

IND-HGBL-DH-1L-DAEPOCHR - IND-HGBL-DH-1L-DAEPOCHR

Questionnaires

QUEST-HGBL-DH-1L-STUB - High-Grade B-Cell Lymphoma, Double-Hit / Triple-Hit — first line