title: Incidence and clinical significance of bcl-2/IgH rearrangements in follicular lymphoma.
abstract: Bcl-2/IgH rearrangement is the molecular hallmark of follicular lymphoma (FL) which is present in 70-90% of the cases at diagnosis. The clinical significance of this feature is controversial. The aim of this study was to analyze the bcl-2/IgH rearrangement by means of a PCR technique, and to correlate molecular findings with clinical characteristics and outcome. Sixty-nine patients (median age, 53 years; male/female ratio: 35/34) diagnosed with FL in a single institution were included in the study. A total of 77 DNA samples were analyzed, 54 were obtained from lymph node biopsy and 23 from peripheral blood or bone marrow. Bcl-2/IgH rearrangement was assessed for both the major breakpoint region (MBR) and the minor cluster region (mcr) breakpoints by a PCR technique. Thirty-nine out of sixty patients (65%) with assessable samples were found to have a bcl-2/IgH rearrangement in the MBR breakpoint, whereas bcl-2/IgH rearrangement in mcr was observed in one patient (2%) and no rearrangement at MBR or mcr in the remaining 20 patients (33%). Regarding the initial characteristics, patients with bcl-2/IgH rearrangements at MBR or mcr were younger (<65 years) than those with no rearrangement at these sites (p = 0.0001). No differences were found according to bcl-2/IgH rearrangement in terms of complete response rate, time to treatment failure and overall survival. In our series bcl-2/IgH rearrangement at MBR or mcr, which was found in 67% of the patients, was not correlated with response to treatment, survival nor time-to-treatment-failure.
authors.affiliation: Hematology Department, Institute of Hematology and Oncology, Postgraduate School of Hematology Farrers-Valenti Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clinic of Barcelona, Villarroel 170, 08036-Barcelona, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Montoto
authors.forename: Armando
authors.initials: A
authors.lastname: López-Guillermo
authors.forename: Dolors
authors.initials: D
authors.lastname: Colomer
authors.forename: Jordi
authors.initials: J
authors.lastname: Esteve
authors.forename: Francesc
authors.initials: F
authors.lastname: Bosch
authors.forename: Ana
authors.initials: A
authors.lastname: Ferrer
authors.forename: Neus
authors.initials: N
authors.lastname: Villamor
authors.forename: Carolina
authors.initials: C
authors.lastname: Moreno
authors.forename: Elías
authors.initials: E
authors.lastname: Campo
authors.forename: Emili
authors.initials: E
authors.lastname: Montserrat
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019457:Chromosome Breakage; D018572:Disease-Free Survival; D005260:Female; D023061:Gene Order / Q000502:physiology*; D019254:Genes, bcl-2 / Q000235:genetics*; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics*; D015994:Incidence; D008224:Lymphoma, Follicular / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011336:Probability; D011379:Prognosis; D012074:Remission Induction; D017211:Treatment Failure
chemical_list: D007143:Immunoglobulin Heavy Chains