title: Specificity of polymerase chain reaction-based clonality analysis of immunoglobulin heavy chain gene rearrangement for the detection of bone marrow infiltrate in B-cell lymphoma-associated haemophagocytic syndrome.
abstract: As a wide range of disorders underlie haemophagocytic syndrome, a rapid distinction between benign polyclonal and malignant monoclonal lymphoid proliferations is critical. We investigated whether polymerase chain reaction (PCR) amplification of immunoglobulin heavy chain gene rearrangement could efficiently detect clonal B-cell populations in non-diagnostic marrow for B-cell lymphoma-associated haemophagocytic syndrome (B-LAHS). On amplifying two DNA samples per biopsy, no reproducible monoclonal PCR result was found in reactive haemophagocytic marrows. In contrast, four out of nine assessable B-LAHS patients with histomorphologically and immunohistochemically lymphoma-free bone marrow showed a reproducible monoclonal immunoglobulin heavy chain gene rearrangement. At the molecular level, two B-LAHS patients had lymphoma-free marrow as demonstrated by patient-specific PCR, suggesting that haemophagocytic marrow is not always associated with lymphoma involvement. PCR-based demonstration of clonal B-cell populations in marrow would add an extra dimension to B-LAHS diagnosis.
authors.affiliation: Department of Medicine II, Okayama University Medical School, Okayama, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kojima
authors.forename: Kinuyo
authors.initials: K
authors.lastname: Kaneda
authors.forename: Masaki
authors.initials: M
authors.lastname: Yasukawa
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tanaka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Inoue
authors.forename: Takuya
authors.initials: T
authors.lastname: Yamashita
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Dansako
authors.forename: Sumie Takase
authors.initials: ST
authors.lastname: Sakugawa
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Kozuka
authors.forename: Masamichi
authors.initials: M
authors.lastname: Hara
authors.forename: Mitsune
authors.initials: M
authors.lastname: Tanimoto
mesh_terms: D000368:Aged; D005260:Female; D015326:Gene Rearrangement, B-Lymphocyte, Heavy Chain; D015616:Histiocytosis, Non-Langerhans-Cell / Q000276:immunology*; D006801:Humans; D007143:Immunoglobulin Heavy Chains; D016393:Lymphoma, B-Cell / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000592:standards*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D007143:Immunoglobulin Heavy Chains