How does your approach differ when managing a "triple hit" versus a "double hit" or "double expressor" lymphoma?

Double-hit lymphoma and double-expressing lymphoma are biologically and clinically distinct entities. DHL is now classified within the WHO as high-grade lymphoma, and the majority are of germinal center immunophenotype, whereas DEL is most typically of non-germinal center immunophenotype and classified not as high-grade lymphoma, but as DLBCL. Studies and therapeutic approaches for lymphoma should not include both under one umbrella, and they should be approached as clinicopathologically distinct entities.

For DHL, no single standard of care exists, but there is a growing body of literature associating "intensified" induction regimens with improved outcomes as compared to RCHOP. For those receiving intensified induction, be it da-R-EPOCH or ...