bcl-2 rearrangements in de novo diffuse large cell lymphoma. Association with distinctive clinical features.
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.
Department of Medicine, Massachusetts General Hospital, Boston.
J O
JO
Jacobson
B M
BM
Wilkes
D J
DJ
Kwaiatkowski
L J
LJ
Medeiros
A C
AC
Aisenberg
N L
NL
Harris
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015322:Gene Rearrangement, B-Lymphocyte / Q000235:genetics*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011519:Proto-Oncogenes / Q000235:genetics*; D016019:Survival Analysis