Probes: BCL6 (3q27) | MYC (8q24) | IgH/BCL2 t(14;18) | Optional probes: MYC/IgH/CEN8 t(8;14) [available to all clients] and BCL2 (18q21) [non-New York clients only]
Disease(s): B-cell lymphoma, double-hit lymphoma, triple-hit lymphoma
This panel differentiates double-hit or triple-hit lymphomas (which have MYC rearrangements together with BCL2 and/or BCL6 rearrangements) from Burkitt lymphoma or diffuse large B-cell lymphoma. Double-hit and triple-hit lymphomas are difficult to classify morphologically without aid of cytogenetics/FISH or IHC, and are associated with an aggressive course. Testing is indicated when B-cell lymphoma patients experience transformation, relapse, or refractory disease. Clients may choose to add MYC/IgH/CEN8 t(8:14) and/or BCL2 breakapart testing to their initial test order. MYC/IgH/CEN8 will confirm heavy chain rearrangement when MYC is rearranged. BCL2 breakapart allows inclusion of BCL2 rearrangements other than IgH/BCL2 t(14;18).
Clients may want to consider the High-Grade B-Cell Lymphoma Reflex FISH Panel as a cost-effective alternative.
- Bone marrow aspirate: 1-2 mL sodium heparin tube. EDTA tube is acceptable.
- Peripheral blood: 2-5 mL sodium heparin tube. EDTA tube is acceptable.
- Fresh, unfixed tissue: Tissue in RPMI.
- Fluids: Equal parts RPMI to specimen volume.
- Paraffin block: H&E slide (required) plus paraffin block. Circle H&E for tech-only.
- Cut slides: H&E slide (required) plus 6 unstained slides cut at 4 microns. Circle H&E for tech-only.
Refrigerate fresh specimens. Do not freeze. Use cold pack for transport, making sure cold pack is not in direct contact with specimen.
4 days for both unfixed and FFPE specimens