B-Cell Lymphomas
B-cell non-Hodgkin lymphomas are a heterogeneous group of malignancies with distinct biology, prognosis, and treatment. Genomic profiling — MYC/BCL2/BCL6 FISH, cell-of-origin GEP, Ki-67, and TP53 — is essential for risk stratification and treatment planning across DLBCL, follicular lymphoma, and mantle cell lymphoma.
Select Subtype — 3 subtypes with recommendations
Diffuse Large B-Cell Lymphoma (DLBCL)
→DLBCL is the most common aggressive B-cell lymphoma (~25% of NHL). Cell-of-origin (GCB vs. ABC/non-GCB) is prognostically critical. MYC/BCL2 double-hit (HGBL) requires intensified induction (DA-EPOCH-R vs. R-CHOP or pola-R-CHP).
Follicular Lymphoma (FL)
→The most common indolent B-cell lymphoma (~20% of NHL). t(14;18) BCL2 overexpression is the hallmark. Ki-67 and TP53 mutation status guide risk stratification. Grade 3B behaves like DLBCL.
Mantle Cell Lymphoma (MCL)
→MCL is characterized by t(11;14) IGH-CCND1 translocation and cyclin D1 overexpression. Ki-67 (MIPI-b) and TP53 mutation status are the critical prognostic biomarkers distinguishing conventional from high-risk/blastoid MCL.