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Journal of Case Reports
B-Cell Precursor Acute Lymphoblastic Leukaemia/Lymphoma with Myc and Bcl-2 Rearrangements, a Case Report of an Unclassified “New” Entity
Roberto Secchi1, Federico Meconi1, Fabiana Esposito1, Annagiulia Zizzari1, Vito Mario Rapisarda1, Ida Provenzano1, Manuela Rizzo1, Lucia Anemona2, Maria Cantonetti1
1Department of Biomedicine and Prevention, Haematology Division, 2Anatomic Pathology, Department of Biomedicine and Prevention, University of Tor Vergata, Viale Oxford 81, Rome, Italy.
Corresponding Author:
Dr Roberto Secchi
Email: robsecchi922@gmail.com
Received: 26-JUN-2020 Accepted: 21-OCT-2020 Published Online: 05-JAN-2021
DOI: http://dx.doi.org/10.17659/01.2021.0001
Background: Lymphomas with Myc and Bcl2 and/or Bcl6 rearrangements, commonly defined as Double hit Lymphomas (DHI) or Triple hit Lymphomas (THI) have a poor prognosis than those with diffuse large B-cell lymphoma (DLBCL) NOS. Combined Myc and Bcl-2 and Bcl-6 rearrangements are reported in rare cases of follicular lymphoma (FL) and acute lymphoblastic B-cell precursor leukemia/lymphoma (BCP-ALL). Case Report: Here in, we report a case of a fifty year-old man, who was referred to our hospital after being diagnosed with de novo DH-BCP-ALL, presenting with both diffuse cranial and spinal meningeal involvement and multiple other extra-nodal localizations (cutaneous, testicular, gastro-enteric and skeletal), in addition to nodal localizations such as para-cardiac and para-renal. After reaching Partial Response (PR) with first line treatment, the patient early relapsed and was refractory to new lines of therapy with an overall survival (OS) of 7 months. Conclusion: BCP-ALL with combination of Myc and Bcl-2 and/or Bcl-6 rearrangements named “De novo DH-BCP-ALLs” have to be classified as a separate entity although they are rare and their clinic immune-phenotypic and cytogenetic features are not well characterized.

Keywords : B-Lymphocytes, Cytogenetic Analysis, Leukemia, Lymphoma, Prognosis.
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