title: PCR-detectable nonneoplastic Bcl-2/IgH rearrangements are common in normal subjects and cancer patients at diagnosis but rare in subjects treated with chemotherapy.
abstract: OBJECTIVE
  To assess whether nonneoplastic Bcl-2/IgH rearrangements act as a confounding factor in the setting of minimal residual disease analysis by evaluating their incidence in a panel of lymphoma-free subjects, including cancer-free donors and chemotherapy-naive and chemotherapy-treated cancer patients.
  
  
  METHODS
  A total of 501 nonlymphoma subjects have been assessed: 258 cancer-free patients and 243 patients with malignancies other than lymphoma, 112 of whom were chemotherapy-naive. Patients were primarily assessed by nested polymerase chain reaction (PCR), followed by real-time quantitative PCR if they scored positive. In addition, six initially PCR-positive cancer-free donors were prospectively reassessed by qualitative and quantitative PCR after 30 and 60 days.
  
  
  RESULTS
  The overall incidence of Bcl-2/IgH positivity was 9.6%, with a median number of 11 rearrangements per 1,000,000 diploid genomes (range, 0 to 2,845 rearrangements), as assessed by real-time PCR. The incidence was similar in healthy subjects and cancer patients at diagnosis (12% and 12.5%; P = not significant). In contrast, the incidence of this translocation was only 2.3% in chemotherapy-treated patients (P <.001). In addition, three initially PCR-positive cancer-free donors showed persistence of their rearrangements when assessed after 30 and 60 days.
  
  
  CONCLUSIONS
  The low incidence of nonneoplastic Bcl-2/IgH rearrangements following chemotherapy provides further evidence of the prognostic role of persistent PCR-positivity in the posttreatment molecular follow-up of follicular lymphoma patients.
authors.affiliation: Divisione di Ematologia, Dipartimento di Medicina ed Oncologia Sperimentale-Universita' di Torino, Italy. marco.ladetto@unito.it
authors.forename: Marco
authors.initials: M
authors.lastname: Ladetto
authors.forename: Daniela
authors.initials: D
authors.lastname: Drandi
authors.forename: Mara
authors.initials: M
authors.lastname: Compagno
authors.forename: Monica
authors.initials: M
authors.lastname: Astolfi
authors.forename: Federica
authors.initials: F
authors.lastname: Volpato
authors.forename: Claudia
authors.initials: C
authors.lastname: Voena
authors.forename: Anna
authors.initials: A
authors.lastname: Novarino
authors.forename: Berardino
authors.initials: B
authors.lastname: Pollio
authors.forename: Alfredo
authors.initials: A
authors.lastname: Addeo
authors.forename: Irene
authors.initials: I
authors.lastname: Ricca
authors.forename: Patrizia
authors.initials: P
authors.lastname: Falco
authors.forename: Federica
authors.initials: F
authors.lastname: Cavallo
authors.forename: Sonia
authors.initials: S
authors.lastname: Vallet
authors.forename: Paolo
authors.initials: P
authors.lastname: Corradini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pileri
authors.forename: Giacomo
authors.initials: G
authors.lastname: Tamponi
authors.forename: Antonio
authors.initials: A
authors.lastname: Palumbo
authors.forename: Oscar
authors.initials: O
authors.lastname: Bertetto
authors.forename: Mario
authors.initials: M
authors.lastname: Boccadoro
authors.forename: Corrado
authors.initials: C
authors.lastname: Tarella
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015321:Gene Rearrangement; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics*; D008224:Lymphoma, Follicular / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000235:genetics*; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000235:genetics*; D014178:Translocation, Genetic
chemical_list: D007143:Immunoglobulin Heavy Chains; D019253:Proto-Oncogene Proteins c-bcl-2