What is double-hit lymphoma (DHL)?
DHL is an aggressive cancer that develops from white blood cells called B lymphocytes. It's sometimes considered a rare subtype of diffuse large B-cell lymphoma (DLBCL), affecting approximately 5 percent of people with DLBCL.
What causes it?
DHL is caused by specific genetic mutations Show Full Answer
What is double-hit lymphoma (DHL)?
DHL is an aggressive cancer that develops from white blood cells called B lymphocytes. It's sometimes considered a rare subtype of diffuse large B-cell lymphoma (DLBCL), affecting approximately 5 percent of people with DLBCL.
What causes it?
DHL is caused by specific genetic mutations called translocations. Most commonly, it involves two genes:
- MYC gene
- BCL2 gene
These pieces of chromosomes break off and combine abnormally, creating mutations that make the cancer harder to treat.
Common symptoms include:
- Swollen lymph nodes
- Fevers
- Night sweats
- Sudden weight loss
- Fatigue
- Trouble breathing
- Loss of appetite
Treatment approaches:
Due to its aggressive nature, intensive treatment regimens are typically recommended, including:
- Intensive chemotherapy combinations like DA-EPOCH-R, R-Hyper-CVAD, or R-CODOX-M/R-IVAC
- Bone marrow transplant for those responsive to chemotherapy
- CNS prophylaxis (treatment to prevent spread to brain and spinal cord)
- Newer immunotherapies like CAR T-cell therapy
DHL tends to be more difficult to treat than other lymphomas and can be refractory (non-responsive) to treatment. Talk with your oncology team about the most current treatment options and what approach would work best for your specific situation.
November 24, 2025
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