Leukemic mantle cell lymphoma: clinical and pathologic spectrum of twenty-three cases.
Twenty-three patients with marked leukemic involvement by mantle cell lymphoma (MCL) are described. Each patient had an absolute lymphocyte count more than 10 x 10(9)/L. The diagnosis of MCL was supported by compatible immunophenotypic findings and the t(11;14)(q13;q32) in all cases. Morphologically, these cases exhibited a spectrum of findings that we divided into two groups using a cutoff of 20% large or blastoid cells (log rank test, P =.004). Patients with small-cell (<20%) morphologic features survived longer than patients with large/blastoid (> or =20%) morphologic features, (P =.003, log rank test). The most common additional karyotypic abnormality identified in this study involved chromosome 17, in 13 of 23 (56.5%) cases, which correlated with p53 overexpression but not with cytologic features. We conclude that cytologic features of MCL predict the prognosis of patients with marked leukemic involvement. Chromosome 17 abnormalities are common in leukemic MCL, may be involved in pathogenesis, and are associated with p53 expression.
Schlette
E
E
Department of Hematopathology, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA. eschlett@mdanderson.org
Lai
R
R
Onciu
M
M
Doherty
D
D
Bueso-Ramos
C
C
Medeiros
L J
LJ
D000328:Adult; D000368:Aged; D018941:Antigens, CD19 / Q000032:analysis; D018951:Antigens, CD20 / Q000032:analysis; D018956:CD5 Antigens / Q000032:analysis; D002880:Chromosomes, Human, Pair 11 / Q000235:genetics; D002883:Chromosomes, Human, Pair 14 / Q000235:genetics; D019938:Cyclin D1 / Q000032:analysis; D005260:Female; D006023:Glycoproteins / Q000032:analysis; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000032:analysis; D007150:Immunohistochemistry; D016130:Immunophenotyping; D007945:Leukemia, Lymphoid / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D020522:Lymphoma, Mantle-Cell / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D014178:Translocation, Genetic; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
D018941:Antigens, CD19; D018951:Antigens, CD20; D018956:CD5 Antigens; D006023:Glycoproteins; D007147:Immunoglobulin Light Chains; C112523:MS4A1 protein, human; D016159:Tumor Suppressor Protein p53; D019938:Cyclin D1