Difuzni B velikostanični limfom (DLBCL) je klasificiran kao limfom različitog entiteta i pomoću genske ekspresije proteina klasificiran je u tri podskupine. Cilj ovog rada je da pojasni kliničke, biološke, imunofenotipske i citogenetske značajke DLBCL s translokacijom t(14;18) i 8q24/c-MYC. Jedanaest bolesnika s DLBCL s dvostrukom translokacijom praćeno je u razdoblju od 2000. do 2009. god. Obilježja tih bolesnika uključuju morfološke, imunohistokemijske i citogenetske analize. Svi bolesnici imaju agresivna obilježja, prisutnost B simptoma (64 %), opće stanje bolesnika prema ECOG ljestvici ≥2 (55 %), povišenu aktivnost serumske laktat dehidrogenaze (73 %), klinički stadij III i IV (82 %), ekstranodalnu zahvaćenost bolesti (73 %), IPI ≥2 (73 %). Parcijalna remisija je postignuta kod 73 %, svi su bolesnici (73 %) umrli u kratkom roku. Bolesnici su liječeni CHOP i sličnim protokolima (COP, CVP, CNOP) uz dodatak Mabthere. Učinjena je imunofenotipizacija te određena ekspresija biljega CD20, CD3, CD10, Bcl6 i MUM1. u svih je učinjena citogenetska analiza ⌠fluorescentna hibridizacija in situ - FISH)⌡i nađene su kompleksne kariotipske promjene. Tako smo analizirali prisutnost gena BCL2, BCL6 i c-MYC, osam bolesnika je imalo translokacije gena BCL2 i c-MYC, dok je troje imalo translokaciju gena BCL6 i c-MYC. Usprkos provedenoj adekvatnoj terapiji, prognoza bolesnika je loša. Medijan preživljenja tih bolesnika je 1,85 godina. Zaključujemo da je DLBCL s BCL2 i c-MYC preuređenjem podskupina limfoma s vrlo lošim preživljenjem. Prisutnost tih dviju translokacija ima agresivan klinički tijek.Diffuse large B-cell lymphoma (DLBCL) is classified as lymphoma and various entities using the gene expression of proteins are classified into three groups. The aim of this study was to clarify the clinical, biological, immunophenotypic and cytogenetic features of DLBCL with translocation t (14; 18) and 8q24/c-MYC. Eleven DLBCL patients with dual translation were monitored during the 2000-2009 period. The characteristics of these patients included morphological, immunohistochemical and cytogenetic analysis. Study results showed that all patients had aggressive characteristics, presence of B symptoms (64%), general patient condition according to ECOG scale ≥2 (55%), elevated serum lactate dehydrogenase activity (73%), clinical stage III and IV (82%), extranodal involvement of the disease (73%), and IPI ≥2 (73%). Partial remission was achieved in 73% of all patients and all patients (73%) died within a short time. Patients were treated with CHOP and similar protocols (COP, CVP, CNOP), with the addition of MabThera. Immunophenotyping was performed and determined expression of the CD20, CD3, CD10, BCL6 and MUM1 markers. The cytogenetic analysis/fluorescence in situ hybridization revealed complex karyotype changes. Thus, we analyzed the presence of BCL2, BCL6 and c-MYC genes and found eight patients to have BCL2 and c-MYC translocation genes, while three had translocation of the BCL6 and c-MYC genes. Despite appropriate therapy, the patient prognosis is poor. The median survival in these patients was 1.85 years. DLBCL with BCL2 and c-MYC rearrangement of the subgroups of lymphoma is associated with very poor survival. The presence of these two translocations has an aggressive clinical course
