Cases approaching 100% ki67 and with deregulation of p53 (p53+ p21-) need to be investigated for MYC rearrangements to exclude Burkitt lymphoma6. Rearrangements of MYC, particularly in association with t(14;18) remain a strong prognostic factor in DLBCL7. Specification (i): Numerator: Number of patients with Burkitt Lymphoma and DLBCL undergoing chemotherapy treatment with curative intent who have MYC results reported prior to treatment. Denominator: All patients with Burkitt Lymphoma and DLBCL undergoing chemotherapy treatment with curative intent. Exclusions No exclusions. (Continued overleaf) QPI 4 Cytogenetic Testing (continued) – Specification (ii): Numerator: Number of patients with Burkitt Lymphoma and DLBCL undergoing chemotherapy treatment with curative intent who have MYC results reported within 3 weeks of commencing treatment. Denominator: All patients with Burkitt Lymphoma and DLBCL undergoing chemotherapy treatment with curative intent. Exclusions No exclusions. Target: Specification (i): 60% Specification (ii): 85% The tolerance within this target accounts for situations where there is no fresh tissue for cytogenetic analysis and there is insufficient tissue for FISH studies. Furthermore, MYC testing may not be appropriate if patients are not suitable for more intensive treatment, i.e. for factors of fitness or due to co-morbidities. QPI separated into 2 parts wording has been revised in specification (i) to – Revisions: specifically state chemotherapy treatment. Specification (ii) added to focus on the availability of MYC results within 3 weeks of commencing treatment (chemotherapy) with more challenging target (85%).
Cases approaching 100% ki67 and with deregulation of p53 (p53+ p21-) need to be investigated for MYC rearrangements to exclude Burkitt lymphoma6. Rearrangements of MYC, particularly in association with t(14;18) remain a strong prognostic factor in DLBCL7. Specification (i): Numerator: Number of patients with Burkitt Lymphoma and DLBCL undergoing chemotherapy treatment with curative intent who have MYC results reported prior to treatment. Denominator: All patients with Burkitt Lymphoma and DLBCL undergoing chemotherapy treatment with curative intent. Exclusions No exclusions. (Continued overleaf) QPI 4 – Cytogenetic Testing (continued) Specification (ii): Numerator: Number of patients with Burkitt Lymphoma and DLBCL undergoing chemotherapy treatment with curative intent who have MYC results reported within 3 weeks of commencing treatment. Denominator: All patients with Burkitt Lymphoma and DLBCL undergoing chemotherapy treatment with curative intent. Exclusions No exclusions. Target: Specification (i): 60% Specification (ii): 85% The tolerance within this target accounts for situations where there is no fresh tissue for cytogenetic analysis and there is insufficient tissue for FISH studies. Furthermore, MYC testing may not be appropriate if patients are not suitable for more intensive treatment, i.e. for factors of fitness or due to co-morbidities. Revisions: QPI separated into 2 parts – wording has been revised in specification (i) to specifically state chemotherapy treatment. Specification (ii) added to focus on the availability of MYC results within 3 weeks of commencing treatment (chemotherapy) with more challenging target (85%).