title: A real-time (PCR) for a real life…? Quantitative evaluation of BCL2/IGH in follicular lymphoma and its implications for clinical practice.
abstract: Follicular lymphoma (FL) is highly associated with the molecular rearrangement BCL2/IGH. Although BCL2/IGH has been studied many times in follicular lymphoma, its real clinical value remains controversial. In this study, we performed quantitative testing by real-time polymerase chain reaction in 56 FL patients with median follow-up of 44 months (range, 9-102 months); chemotherapy was administered in 52 of 56 cases. Pretreatment numbers of BCL2/IGH varied in wide ranges, with a median of 2947 (range, 0-1,261,013) copies/10(6) cellular equivalent in peripheral blood (PB) and 4650 copies/10(6) cellular equivalent (range, 1-1,056,813) in bone marrow (BM), the difference between PB and BM was significant (p = 0.006). Pretreatment of BCL2/IGH quantities were correlated to clinical parameters (e.g., age, stage, sex, lactate dehydrogenase, B symptoms, grade, bulky disease, chemotherapy regimen) and to progression free-survival. Advanced clinical stage (III and IV) and microscopic BM involvement were significantly associated with higher numbers of BCL2/IGH in PB (p < 0.05) and in BM (p = 0.05), regardless all or newly diagnosed patients were evaluated. High pretreatment burden of BCL2/IGH was associated with significantly shorter progression-free survival; p = 0.003 and p = 0.047 for PB and BM, respectively. In conclusion, pretreatment quantity of BCL2/IGH in PB or BM seems to mirror the extent of disease and can provide an auxiliary prognostic parameter in FL. Our results also support evidence of the negative prognostic value of microscopic BM involvement in FL.
authors.affiliation: Department of Internal Medicine--Hematooncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic. ajanikova@fnbrno.cz
authors.forename: Andrea
authors.initials: A
authors.lastname: Janikova
authors.forename: Andrea
authors.initials: A
authors.lastname: Mareckova
authors.forename: Dana
authors.initials: D
authors.lastname: Dvorakova
authors.forename: Zbynek
authors.initials: Z
authors.lastname: Bortlicek
authors.forename: Boris
authors.initials: B
authors.lastname: Tichy
authors.forename: Milan
authors.initials: M
authors.lastname: Navratil
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Kral
authors.forename: Sarka
authors.initials: S
authors.lastname: Pospisilova
authors.forename: Jiri
authors.initials: J
authors.lastname: Mayer
mesh_terms: D000328:Adult; D000368:Aged; D001853:Bone Marrow / Q000378:metabolism / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007143:Immunoglobulin Heavy Chains; D008224:Lymphoma, Follicular / Q000097:blood / Q000188:drug therapy / Q000235:genetics / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015514:Oncogene Proteins, Fusion; D019253:Proto-Oncogene Proteins c-bcl-2; D012334:RNA, Neoplasm / Q000097:blood* / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate; D014178:Translocation, Genetic
chemical_list: D007143:Immunoglobulin Heavy Chains; D015514:Oncogene Proteins, Fusion; D019253:Proto-Oncogene Proteins c-bcl-2; D012334:RNA, Neoplasm