What biomarker tests should I ask my doctor about

Based on the NCCN Guidelines for Patients, here are the key biomarker tests you should discuss with your doctor for Lymphoma:

For Follicular Lymphoma (FL): According to the NCCN Guidelines for FL (2024), essential biomarker testing includes:

1. Immunophenotyping tests:

• Immunohistochemistry (IHC) panel testing for markers including:
• CD20, CD3, CD5, CD10, BCL2, BCL6, CD21/CD23
• Flow cytometry testing for:
• Kappa/lambda, CD19, CD20, CD5, CD23, CD10

1. Genetic testing:

• BCL2 and BCL6 rearrangements
• Testing for chromosome translocations
• Fluorescence in situ hybridization (FISH) studies

For Diffuse Large B-Cell Lymphoma (DLBCL): According to the NCCN Guidelines for DLBCL (2025), key biomarker testing includes:

1. Essential genetic tests:

• MYC, BCL2, and BCL6 gene rearrangements
• FISH testing for these rearrangements if MYC is positive
• Karyotype testing

1. Immunophenotyping:

• IHC panel including CD3, CD20, CD10, BCL2, BCL6, IRF4/MUM1, and MYC
• Flow cytometry markers including CD3, CD5, CD19, CD10, CD20, CD45

The guidelines emphasize that these tests should be interpreted by expert pathologists and are crucial for accurate diagnosis and treatment planning. Always discuss the full panel of appropriate tests with your healthcare team, as individual needs may vary.

Sources:

• NCCN Guidelines for Patients: Follicular Lymphoma, 2024
• NCCN Guidelines for Patients: Diffuse Large B-Cell Lymphomas, 2025