bcl-2 Rearrangements in de novo diffuse large cell lymphoma. Association with distinctive clinical features

Abstract

Background. The frequency and clinical significance of bcl‐2 rearrangement in de novo B‐cell diffuse large cell lymphoma is largely unknown. Methods. Using Southern blot hybridization and multiple DNA probes, the status of the protooncogene bcl‐2 was investigated in frozen tissue samples from 45 carefully selected cases of de novo diffuse large cell lymphoma of B‐cell origin. Results were correlated with the presenting clinical and immunophenotypic features and with the subsequent clinical course. Results. Rearrangements of bcl‐2 were identified in nine tumor specimens (20%). The bcl‐2‐positive cases more often presented as early‐stage, nonmucosal associated extranodal tumors (P = 0.06) and were more often HLA‐DR negative (P = 0.07). Five‐year failure‐free survival was poor among the bcl‐2‐positive cases (11% versus 48%). Overall survival was no different, however, because relapses in bcl‐2‐positive cases tended to be responsive to further therapy. Conclusions. Analysis of bcl‐2 rearrangements in de novo diffuse large cell lymphoma may identify a subset of patients with unusual clinical features. Cancer 1993; 72:231–6.

Grading follicular lymphoma on fine-needle aspiration specimens-A practical approach

“…However the bcl-2 gene rearrangement t(14;18)(q32;q21), which juxtaposes the bcl-2 gene with the immunoglobulin heavy-chain locus, resulting in deregulated expression of bcl-2, is present in approximately 80 -90% of FLs, is highly specific, and is detected readily by polymerase chain reaction and fluorescence in situ hybridization (FISH) analyses. 23,24 Although bcl-2 gene rearrangements also can be detected in certain diffuse large B-cell lymphomas (DLBL), 25 analyzing bcl-2 gene rearrangement in Grade 1 or 2 FL with atypical phenotype (CD10-negative or dimly positive lymphomas) may be useful for more definitive differentiation from other small cell lymphomas. It also is helpful to note that BCL-6 protein, which some believe is important in germinal center formation, is a sensitive marker of FL.…”

Design and standardization of PCR primers and protocols for detection of clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: Report of the BIOMED-2 Concerted Action BMH4-CT98-3936

“…A t(14;18) was detected in two further cases by PCR; FR-6, a case of DLBCL showed an MBR breakpoint and was identified by all 11 laboratories, this finding is compatible with previous studies that have detected a t(14;18) in 20-40% of DLBCL cases. 171,172 Using the 3 0 MBR multiplex, 10/11 laboratories reported a positive result for sample ES-12, this was a case of Hodgkin's disease that contained very few B cells. It is difficult to explain this result in the absence of an IGH rearrangement by Southern blotting.…”

t(14;18), a journey to eternity

“…No such effect was found in many other studies involving follicular NHL or DLCL patients. [26][27][28][29][30] The t(14;18) has been correlated in several studies with a lower incidence of complete remission after chemotherapy and decreased disease-free survival in follicular NHL and DLCL. 25,27,31,32 Since overall survival is not affected, these results indicate that relapses are responsive to further treatment.…”