Primary Refractory Double Hit Diffuse Large B Cell Lymphoma: Complete Response to Ibrutinib and Rituximab

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Double hit lymphoma (DHL) associated with translocations in MYC and BCL-2 or BCL-6 gene accounts for approximately 5-10 % of all diffuse large B cell lymphoma (DLBCL) [1]. These patients are distinct from double-expressers who stain positive on
immunohistochemistry for MYC and BCL2 or BCL6 accounting for approximately 25-35% of all DLBCL. Double expresser DLBCL have relatively poor outcomes but DHL is associated with extremely aggressive course and poor prognosis. With R-CHOP, R-EPOCH or similar induction therapy a complete response rates of 30-70% have been reported for DHL with 5 years survival of only 27-36%.

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