title: Prognostic and predictive significance of the bcl-2/IgH translocation in malignant follicular lymphomas.
abstract: BACKGROUND
  The t(14;18) translocation, which leads to an overproduction of the bcl-2 protein, supposedly occurs in almost all follicular lymphomas (FL) and can be detected by FISH methods or by PCR. Its detection is useful in monitoring the response to therapy and in assessing minimal residual disease in bone marrow. Recently it was observed that the translocation could become negative after treatment. The prognostic and predictive significance of this fluctuation is not entirely understood.
  
  
  OBJECTIVE
  We intended to find significant correlations among morphological features, histological grades, immunohistochemical findings, and cytogenetical aberrations in malignant follicular lymphomas, in order to identify the prognostic and predictive value of the bcl-2/IgH translocation in these malignancies.
  
  
  METHODS
  We conducted a study on 79 patients with follicular lymphomas. The study was carried out on tissue samples selected from the "Victor Babes" National Institute of Pathology files. These samples were tested by immunohistochemistry and FISH.
  
  
  RESULTS
  Most of the cases (65.2%) were low-grade FL (grade 1-2). Approximately 58.8% of cases in the FISH study group presented t(14;18). In 66.6% of the cases with t(14;18), the immunohistochemical reaction for bcl-2 protein was positive. A significant positive correlation was found between the IHC positivity for bcl-2 and t(14;18) detected by FISH (p=0.04).
  
  
  CONCLUSIONS
  Bcl-2 t(14;18) plays an important role in the pathogenesis of follicular lymphoma. FISH is an important tool in the diagnosis, treatment and follow up of these malignancies, since the immunohistochemical testing is negative in a significant proportion of cases.
authors.affiliation: Department of Pathology, Victor Babes, National Institute of Pathology, Bucharest, Romania. georgescu.alina@gmail.com
authors.forename: Alina
authors.initials: A
authors.lastname: Georgescu
authors.forename: M
authors.initials: M
authors.lastname: Stoicea
authors.forename: Maria
authors.initials: M
authors.lastname: Comănescu
authors.forename: Camelia
authors.initials: C
authors.lastname: Dobrea
authors.forename: F
authors.initials: F
authors.lastname: Andrei
authors.forename: Maria
authors.initials: M
authors.lastname: Neagu
authors.forename: Florina
authors.initials: F
authors.lastname: Cionca
authors.forename: Anca
authors.initials: A
authors.lastname: Ciobanu
authors.forename: Anca
authors.initials: A
authors.lastname: Lupu
authors.forename: Carmen
authors.initials: C
authors.lastname: Ardeleanu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002883:Chromosomes, Human, Pair 14; D002887:Chromosomes, Human, Pair 18; D005260:Female; D050438:Genes, Immunoglobulin Heavy Chain; D019254:Genes, bcl-2; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008224:Lymphoma, Follicular / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D014178:Translocation, Genetic; D055815:Young Adult
chemical_list: D019253:Proto-Oncogene Proteins c-bcl-2