In this study, methylation-specifi c polymerase chain reaction was used to investigate the potential prognostic signifi cance of the methylation status of p15 , p16, MGMT , and DAPK genes in 51 specimens of diffuse large B-cell lymphoma (DLBCL). Hypermethylation of p15 gene was signifi cantly more prevalent in patients without relapse ( p = 0.001) and there was a trend toward more frequent presence of p15 methylation in patients without death outcome within 5-year follow-up period ( p = 0.086) Also, there was a trend toward accumulation of p15 methylation with favorable clinicopathological parameters including: age ≤ 60 years ( p = 0.091), normal levels of lactate dehydrogenase ( p = 0.090), Eastern Cooperative Oncology Group performance status < 2 ( p = 0.095), and low/intermediate low International Prognostic Index ( p = 0.076). In the female group and group of the patients without bulky tumor mass, treated with chemotherapeutic regimens including rituximab, methylation of p15 was signifi cantly related to longer overall survival ( p = 0.036 and 0.027, respectively). Our results suggest that promoter methylation of p15 gene could have prognostic value in DLBCL patients treated with rituximab when used in combination with gender and tumor size. Clin Trans Sci 2014; Volume 7: 384-390Keywords: diffuse large B-cell lymphoma , methylation, p15 , prognosis , rituximab 385 VOLUME 7 • ISSUE 5 WWW.CTSJOURNAL.COM Krajnović et al. ■ Hypermethylation of p15 Gene in DLBCL considered positive for Bcl-2, Bcl-6, or CD10 when at least 50%, 10%, or 20% of tumor cells expressed Bcl2, Bcl6, or CD10 protein, respectively. Expression of Ki67 protein in 0-30% of tumor cells was considered as weak, in 30-60% of tumor cells as moderate, and in more than 60% of the cells as strong. All procedures were carried out with the prior informed consent of the patients and with the approval of the local Ethic Committee. Treatment consisted of CHOP/R-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone with or without rituximab) regimen. Some patients had adjuvant radiotherapy and/or surgery, and some of them underwent autologous stem-cell transplantation. Response criteria and survival outcomes were defi ned according to the recommendation of Cheson et al. 17Analysis of methylation status of the p15 , p16 , MGMT , and DAPK genes DNA methylation patterns in the promoter CpG islands of the p15 , p16 , MGMT , and DAPK genes were determined in all of 51 samples by methylation-specifi c polymerase chain reaction (MSP) following the bisulfi te modifi cation of isolated genomic DNA, as described earlier.18 Briefl y, DNA was isolated from deparaffi ned tumor specimens using standard proteinase K, phenol/chloroform/isoamyl alcohol extraction, and ethanol precipitation.19 Two micrograms of isolated DNA were denatured by NaOH (fi nal 0.3 mol/L) at 42°C for 30 minutes and modifi ed by sodium bisulfi te (5.20-5.69 mol/L, pH 5.0, Sigma, St Louis, MO, USA) for 18 hours at 50°C . Aft er incubation, DNA was purifi ed using the DNA extraction...
Two patients with lymphoplasmacytic lymphoma, and monoclonal proteins of IgM in one, and IgG and lambda light chains in the second patient, nephrotic syndrome and acute renal failure are reported. A 58-year-old man previously treated for pre-B acute lymphoblastic leukemia, developed 3 years later nephrotic syndrome as a complication of lymphoplasmacytic lymphoma and high-paraprotein IgM kappa type. Immunofluorescent analysis of kidney biopsy showed extensive IgM and light kappa chain deposits, which caused membranoproliferative glomerulonephritis. Treatment with cyclophosphamide was ineffective and patient died 2 months later. The second patient is a 42-year-old female diagnosed with lymphoplasmacytic lymphoma and paraprotein IgG lambda type. The course of the disease was fulminant with developing nephrotic syndrome and fatal acute renal failure. Immunofluorescent and light microscopic studies of kidney biopsy showed signs of immunotactoid glomerulonephritis with deposits of IgG and C3. Hemodyalises and cytostatic therapy were without response and she died after 45 days.
EMP of the tongue base is a very rare entity of plasma cell dyscrasias. Appropriate irradiation results in the achievement of a long-term remission and a potential cure of the disease.
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