title: Peripheral blood involvement in non-Hodgkin's lymphoma detected by clonal gene rearrangement as a biological prognostic marker.
abstract: Peripheral blood from 67 patients with non-Hodgkin's lymphoma was examined at initial diagnosis for the presence of circulating lymphoma cells by DNA hybridisation using immunoglobulin and T-cell receptor gene probes. Clonal gene rearrangement was found in 31% (21/67) of patients and correlated with clinical stage, histological grade and bone marrow involvement. Clinical stage and the presence of lymphoma cells in peripheral blood were prognostic factors for progression-free survival in all patients on univariate analysis, but the detection of lymphoma cells was not independent of stage. It was also not a significant predictor for survival. In patients with intermediate- and high-grade lymphoma, the detection of lymphoma cells in peripheral blood was a significant prognostic factor for progression-free survival (PFS) and survival only on univariate analysis. The 3-year PFS was 17% in patients with circulating lymphoma cells compared with 75% if these were absent (P < 0.05). The presence of lymphoma cells in peripheral blood is associated with extensive disease and may be a biological marker of poor disease control. Sensitive techniques of detection should form part of large prospective studies in non-Hodgkin's lymphoma.
authors.affiliation: Academic Unit of Radiotherapy and Oncology, Institute of Cancer Research, Sutton, Surrey, UK.
authors.forename: L R
authors.initials: LR
authors.lastname: Hiorns
authors.forename: J
authors.initials: J
authors.lastname: Nicholls
authors.forename: J P
authors.initials: JP
authors.lastname: Sloane
authors.forename: A
authors.initials: A
authors.lastname: Horwich
authors.forename: S
authors.initials: S
authors.lastname: Ashley
authors.forename: M
authors.initials: M
authors.lastname: Brada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015329:Gene Rearrangement, T-Lymphocyte; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000097:blood* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis