Disruption of the physiologic balance between cell proliferation and death is a universal feature of all cancers. In general terms, human B-cell lymphomas can be subdivided into 2 main groups, low-and high-growth fraction lymphomas, according to the mechanisms through which this imbalance is achieved. Most types of low-growth fraction lymphomas are initiated by molecular events resulting in the inhibition of apoptosis, such as translocations affecting BCL2, in follicular lymphoma, or BCL10 and API2/MLT1, in mucosa-associated lymphoid tissue (MALT) lymphomas. This results in cell accumulation as a consequence of prolonged cell survival. In contrast, high-growth fraction lymphomas are characterized by an enhanced proliferative activity, as a result of the deregulation of oncogenes with cell cycle regulatory functions, such as BCL6, in large B-cell lymphoma, or c-myc, in Burkitt lymphoma. Low-and high-growth fraction lymphomas are both able to accumulate other alterations in cell cycle regulation, most frequently involving tumor suppressor genes such as p16 INK4a , p53, and p27 KIP1 . As a consequence, these tumors behave as highly aggressive lymphomas. The simultaneous inactivation of several of these regulators confers increased aggressivity and proliferative advantage to tumoral cells. In this review we discuss our current knowledge of the alterations in each of these pathways, with special emphasis on the deregulation of cell cycle progression, in an attempt to integrate the available information within a global model that describes the contribution of these molecular changes to the genesis and progression of B-cell lymphomas.
IntroductionAlthough studies in experimental models and analyses of virusinduced cell transformation have shown that cell cycle subversion is a key step in tumorigenesis, the available information on human tumors has only recently reached the critical threshold of knowledge that allows a reasonably clear understanding of the mechanisms of cell cycle inactivation and their contribution to the genesis and progression of human cancer. Here, we have chosen B-cell lymphoproliferative lesions on the understanding that the accumulation of data concerning alterations in specific key genes makes it possible to propose a general model that describes the role of these specific alterations in cell cycle regulators in the initiation and progression of these tumors.Lymphoma/leukemia is a group of different types of cancer of the lymphoid system, in which numerous entities feature distinctive molecular alterations (Table 1). The most frequent types of lymphoma are collectively denominated B-cell lymphomas (BCLs), a term that encompasses different entities with variable clinical behavior and diverse molecular features. Nevertheless, in general terms, it is possible to segregate BCLs into 2 main groups, defined as low-and high-growth fraction lymphomas that roughly overlap with previous definitions of low-and high-histologic grade.Low-growth fraction BCLs, including follicular lymphoma (FL), marginal zo...