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Double-hit and triple-hit lymphoma

A high-grade B-cell lymphoma with more than 1 major lymphoma-related genetic change in the lymphoma cells might be called:

= ‘double-hit’ lymphoma (2 major changes), or

= ‘triple-hit’ lymphoma (3 major changes).

Some double-hit and triple-hit lymphomas are a type of DLBCL. Others have features of both Burkitt lymphoma and DLBCL and are unclassifiable into a specific type of high-grade B-cell lymphoma.

Double-hit and triple-hit lymphomas often start in extranodal sites (outside the lymph nodes). Symptoms vary, depending on exactly where the lymphoma starts.

Double-hit and triple-hit lymphomas seem to behave more aggressively than the more common types of DLBCL and may need more intensive treatment.

How are rare high-grade B-cell lymphomas treated?

There is no standard treatment for grey zone lymphoma, double-hit or triple-hit lymphoma or high-grade B-cell lymphoma, NOS. Because these lymphomas are rare, it may take time to find out what treatment will work best.

Most people with grey zone lymphoma or high-grade B-cell lymphoma NOS have the same treatment used for DLBCL or PMBL. If your doctor thinks your lymphoma is more likely to behave like Burkitt lymphoma or classical Hodgkin lymphoma, instead, they might suggest the treatments commonly used for these types of lymphoma. You might be offered an intensive treatment if your lymphoma has features that suggest it may be difficult to treat.

Double-hit and triple-hit lymphoma can be difficult to treat and have higher relapse rates (the lymphoma coming back) than more common types of DLBCL. If you are fit enough, your doctor might suggest intensive chemo-immunotherapy (chemotherapy with antibody therapy). Some people might be offered a stem cell transplant after successful treatment. Stem cell transplants may reduce the risk of relapse.

Some people might be offered treatment as part of a clinical trial. Some clinical trials aim to find out which existing treatment regimen (combination of drugs) works best for these rare lymphomas. Other clinical trials test newer drugs and new combinations of treatments to find out if they are effective.

How can I find information about a rare high-grade B-cell lymphoma?

It can be difficult to find relevant information if your lymphoma does not fit into any of the more usual types. Ask your doctor for advice on what information is most relevant for you. They can advise you based on your individual circumstances.