Coexistent rearrangements of c-MYC, BCL2, and BCL6 genes in a diffuse large B-cell lymphoma.
We present a patient with stage III de novo diffuse large B-cell lymphoma. The lymphoma cells showed mature B-cell immunophenotype but lacked surface immunoglobulin (Ig) expression. Long-distance and long-distance inverse polymerase chain reaction assays to detect the oncogene/Ig gene rearrangement revealed that the cells carried 3 independent fusion genes, namely, c-MYC/Ig heavy chain gene (IgH), BCL2/IgH, and Ig lambda light chain gene/BCL6. Thus, the lymphoma cells concurrently carried t(8;14)(q24;q32), t(14;18)(q32;q21), and t(3;22)(q27;q11), which developed in association with class switching, V/D/J recombination, and somatic hypermutation, respectively. The lymphoma responded to chemoradiotherapy, and the patient has been well for 2 years, suggesting that multiple oncogene rearrangements may not necessarily be associated with poor clinical outcome.
Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. kyotolsg@kuhp.kyoto-u.ac.jp
Chiyoko
C
Ueda
Momoko
M
Nishikori
Toshio
T
Kitawaki
Takashi
T
Uchiyama
Hitoshi
H
Ohno
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage; D002877:Chromosomes, Human / Q000235:genetics / Q000648:ultrastructure*; D002883:Chromosomes, Human, Pair 14 / Q000235:genetics / Q000648:ultrastructure; D002887:Chromosomes, Human, Pair 18 / Q000235:genetics / Q000648:ultrastructure; D002892:Chromosomes, Human, Pair 22 / Q000235:genetics / Q000648:ultrastructure; D002893:Chromosomes, Human, Pair 3 / Q000235:genetics / Q000648:ultrastructure; D002898:Chromosomes, Human, Pair 8 / Q000235:genetics / Q000648:ultrastructure; D003131:Combined Modality Therapy; D004268:DNA-Binding Proteins / Q000235:genetics*; D003907:Dexamethasone / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D019254:Genes, bcl-2; D016259:Genes, myc; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000235:genetics* / Q000532:radiotherapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000235:genetics* / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D011518:Proto-Oncogene Proteins / Q000235:genetics*; D051560:Proto-Oncogene Proteins c-bcl-6; D011519:Proto-Oncogenes; D018714:Radiotherapy, Adjuvant; D012074:Remission Induction; D014157:Transcription Factors / Q000235:genetics*; D014178:Translocation, Genetic
D004268:DNA-Binding Proteins; D011518:Proto-Oncogene Proteins; D051560:Proto-Oncogene Proteins c-bcl-6; D014157:Transcription Factors; D005047:Etoposide; D003907:Dexamethasone; D016190:Carboplatin; D007069:Ifosfamide