BACKGROUND High-grade B-cell lymphomas (HGBCL) with MYC and BCL2 or/and BCL6 rearrangements (R), so-called double/triple-hit lymphomas (DH/THL), are uncommon, clinically aggressive lymphomas that require a prompt diagnosis. We aim to identify flow cytometric immunophenotypic (IP) features of DH/THL that may aid in triaging these cases followed by a timely confirmatory cytogenetic study. METHODS We compared the IP features of 43 cases of DH/THL to those of 55 cases of single-hit lymphoma (SHL) and 59 cases of diffuse large B-cell lymphoma (DLBCL) without MYC-R (MYCneg DLBCL). We analyzed the expression patterns of CD10, CD19, CD20, CD38, and surface immunoglobulin light chain in lymphoma cells. RESULTS Bright CD38 expression (CD38bright ) analyzed either qualitatively or semi-quantitatively was more common in DH/THL (56%) than in MYCneg DLBCL (17%) but less common compared to SHL (82%), indicating that CD38bright can serve as a biomarker for DH/THL. Additionally, CD38bright may be a better indicator for predicting DH/THL-BCL2 than DHL-BCL6, and very bright CD38 expression was exclusive to MYC rearranged lymphomas. The expression patterns of other markers were similar among these lymphoma groups. CONCLUSIONS CD38bright is a biomarker associated with DH/THL with a moderate sensitivity (~50%) and high specificity (~90%). While this marker cannot be used as a screening tool, awareness of this correlation may aid in expediting the diagnosis and prioritizing FISH testing in resource limited settings or situations when samples are limited. Future studies to combine immunohistochemical markers are needed to further enhance the predictive power of CD38bright in diagnosing DH/THL. © 2019 International Clinical Cytometry Society.

中文翻译：

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流式细胞术分析显示明亮的CD38表达是具有中等敏感性和高特异性的双/三重淋巴瘤的生物标志物。

背景伴有MYC和BCL2或/和BCL6重排（R）的高度B细胞淋巴瘤（HGBCL），即所谓的双重/三重淋巴瘤（DH / THL），是罕见的临床侵袭性淋巴瘤，需要迅速诊断。我们旨在确定DH / THL的流式细胞仪免疫表型（IP）特征，有助于对这些病例进行分类，然后进行及时的确认性细胞遗传学研究。方法我们比较了43例DH / THL，55例单发性淋巴瘤（SHL）和59例无MYC-R（MYCneg DLBCL）的弥漫性大B细胞淋巴瘤（DLBCL）的IP特征。我们分析了CD10，CD19，CD20，CD38和表面免疫球蛋白轻链在淋巴瘤细胞中的表达模式。结果DH / THL（56％）中定性或半定量分析的明亮CD38表达（CD38bright）比MYCneg DLBCL（17％）更常见，但与SHL（82％）相比较不常见，表明CD38bright可以作为DH / THL的生物标志物。另外，与DHL-BCL6相比，CD38bright可能是预测DH / THL-BCL2的更好指标，非常明亮的CD38表达是MYC重排淋巴瘤所独有的。在这些淋巴瘤组中，其他标志物的表达模式相似。结论CD38bright是与DH / THL相关的生物标志物，具有中等敏感性（〜50％）和高特异性（〜90％）。尽管此标记不能用作筛选工具，但对这种相关性的了解可能有助于加快诊断速度，并在资源有限的环境中或样本有限的情况下优先进行FISH检测。需要进一步结合免疫组织化学标记物的研究，以进一步增强CD38bright在诊断DH / THL中的预测能力。©2019国际临床细胞计量学会。