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Related Concept Videos

Primary Lymphoid Organs01:16

Primary Lymphoid Organs

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Primary lymphoid organs are pivotal in the formation, development, and maturation of lymphocytes, the white blood cells that serve as the backbone of our immune system. This crucial function underscores their fundamental role in maintaining our overall health and immunity. The two primary lymphoid organs of prime importance are the red bone marrow and the thymus.
The red bone marrow is a soft, spongy tissue nestled in the interior of long bones such as the humerus and femur. It is the site...
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Related Experiment Video

Updated: Dec 27, 2025

Multiplexed Fluorescent Immunohistochemical Staining, Imaging, and Analysis in Histological Samples of Lymphoma
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Double-Hit and Triple-Hit Follicular Lymphoma.

Jessica B Ziemba1, Zena Wolf1, Matthew Weinstock2

  • 1Department of Pathology, Boston, MA.

American Journal of Clinical Pathology
|March 1, 2020
PubMed
Summary
This summary is machine-generated.

Double-hit and triple-hit follicular lymphoma present with high stage disease and worse survival than classic follicular lymphoma. Aggressive therapy may improve outcomes, but further research is needed.

Keywords:
MYC rearrangementFollicular lymphomaDouble hitLymphomaTriple hit

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Area of Science:

  • Hematology
  • Oncology
  • Pathology

Background:

  • Follicular lymphoma (FL) is a common non-Hodgkin lymphoma.
  • MYC and BCL2/BCL6 rearrangements define aggressive subtypes of FL.
  • Characterizing these aggressive variants is crucial for treatment stratification.

Observation:

  • This study analyzed 3 cases and 37 published cases of FL with MYC and BCL2/BCL6 rearrangements.
  • Patients often presented with low-grade but advanced-stage disease.
  • Absence of B symptoms was common despite high-stage disease.

Findings:

  • Double-hit and triple-hit FL demonstrated poorer overall survival compared to classic FL.
  • The etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (EPOCH-R) regimen showed promising results in a small sample.
  • Aggressive pathologic features like angioinvasion and high proliferation index warrant MYC rearrangement testing.

Implications:

  • Double-hit and triple-hit FL may represent a distinct clinicopathologic entity.
  • Consideration of aggressive chemotherapy regimens, similar to those for high-grade B-cell lymphoma with MYC rearrangements, is warranted.
  • Further evidence is required to establish aggressive therapy as the standard of care for these aggressive FL subtypes.