High-Grade B-Cell Lymphoma with MYC and BCL2 and/or BCL6 rearrangements (double-hit / triple-hit)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DIS-HGBL-DH |
|---|---|
| Type | Disease |
| Aliases | DH/THLDouble-hit lymphomaHGBLHGBL-DHHigh-Grade B-Cell Lymphoma, Double-Hit / Triple-HitВисокозлоякісна B-клітинна лімфома з MYC + BCL2/BCL6 (double-hit / triple-hit) |
| Status | reviewed 2026-04-25 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-NCCN-BCELL-2025 |
Informational support. All recommendations must be verified by a qualified oncologist. Engineering checks are not clinical validation or treatment approval.
| icd_o_3_morphology | 9680/3 |
|---|---|
| icd_10 | C83.3 |
| who_classification | Aggressive B-cell lymphomas — High-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements per WHO 5th ed. |
Notes
Mandatory FISH break-apart for MYC + BCL2 + BCL6 on every newly- diagnosed DLBCL — without it, double-hit is missed. Distinct from Burkitt (Ki67 ~100%, BCL2−) by Ki67 typically 70-90% + BCL2+.
Used By
Actionability
BMA-BCL2-REARRANGEMENT-HGBL-DH- BCL2-R as the partner of MYC-R defines HGBL-DH. Same management as MYC-R cell: DA-EPOCH-R...BMA-MYC-REARRANGEMENT-HGBL-DH- HGBL with MYC + BCL2 (and/or BCL6) rearrangements ('double-hit' / 'triple-hit') has aggre...
Algorithms
ALGO-HGBL-DH-1L- ALGO-HGBL-DH-1LALGO-HGBL-DH-2L- ALGO-HGBL-DH-2L
Disease
DIS-BURKITT- Burkitt LymphomaDIS-DLBCL-NOS- Diffuse Large B-Cell Lymphoma, NOS
Indication
IND-HGBL-DH-1L-DAEPOCHR- IND-HGBL-DH-1L-DAEPOCHRIND-HGBL-DH-1L-RCHOP- IND-HGBL-DH-1L-RCHOPIND-HGBL-DH-2L-CART-AXICEL- IND-HGBL-DH-2L-CART-AXICEL
Questionnaires
QUEST-HGBL-DH-1L-STUB- High-Grade B-Cell Lymphoma, Double-Hit / Triple-Hit — first line
Red flag
RF-DLBCL-HIGH-RISK-BIOLOGY- High-risk biology in DLBCL NOS: double-expressor (MYC + BCL2 by IHC, no rearrangement), T...RF-HGBL-DH-CNS-PROPHYLAXIS-TRIGGER- HGBL double-/triple-hit lymphoma — biology alone meets CNS-prophylaxis indication indepen...RF-HGBL-DH-EMERGENCY-TLS- High-grade B-cell lymphoma double-/triple-hit with active or imminent TLS at diagnosis: L...RF-HGBL-DH-FRAILTY-AGE- Age >75 OR ECOG ≥3 — DA-EPOCH-R toxicity prohibitive; modified R-CHOP + IT MTX prophylaxi...RF-HGBL-DH-HIGH-RISK-BIOLOGY- MYC + BCL2 (and/or BCL6) rearrangement (double-/triple-hit) confirmed by FISH — DA-EPOCH-...RF-HGBL-DH-INFECTION-SCREENING- HBV/HCV/HIV serology mandatory pre-rituximab; HIV-associated HGBL-DH gets cART optimizati...RF-HGBL-DH-ORGAN-DYSFUNCTION- Cardiac dysfunction (LVEF <50%) — DA-EPOCH-R (preferred for HGBL-DH/-TH) is anthracycline...RF-HGBL-DH-TRANSFORMATION-PROGRESSION- PET-2 progression (Deauville 4-5 with new lesions) or end-of-induction non-CR — HGBL-DH r...
Sources
SRC-ESMO-DLBCL-2024- ESMO Clinical Practice Guideline on Diffuse Large B-Cell LymphomaSRC-ESMO-LYMPHOMA-2025- Lymphomas: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up