title: Bcl-2/IgH expression of diffuse large B-cell lymphoma cells in minimal bone marrow infiltration.
abstract: BACKGROUND
  We sought to investigate the role of the Bcl-2 translocation at the chromosomal and protein levels in minimal bone marrow (BM) infiltration by diffuse large B-cell lymphomas (DLBCL).
  
  
  METHODS
  The presence of the Bcl-2/IgH fusion gene was detected in BM samples and paraffin-embedded lymph node (LN) samples from 103 patients with DLBCLs using FISH. Bcl-2 protein levels in BM and paraffin-embedded tissues were quantified using immunocytochemistry (ICC) and immunohistochemistry (IHC), respectively.
  
  
  RESULTS
  Bcl-2/IgH translocation in paraffin-embedded LN tissue sections was observed in 43 (41.7%) patients by FISH. Of the 43 patients, the Bcl-2/IgH rearrangement in the bone marrow specimens occurred in 34 patients. The Bcl-2/IgH recombination rate in stage III cancers was not significantly different compared to the rate observed in stage I/II cancers (p = 0.101), respectively showing no statistical differences between stage IV and I/II (p = 0.179). In 64.7% (22/34) of the cases with t(14;18), Bcl-2 was detected based on ICC analysis. Positive Bcl-2 ICC staining and the t(14;18) translocation were positively correlated (p < 0.001). We then applied our FISH method to slides with at least one abnormal cell and were subjected to FISH analysis after staining. During the follow-up, no infiltration by cytomorphology for 16 DLBCL patients whose bone marrow presented Bcl-2/IgH gene rearrangement at diagnosis, and two cases were positive by morphology compared to FISH-positive results 6 months later; 9 out of 16 patients (56.3%) presented with positive Bcl-2/IgH results earlier than the morphology evaluation after 12 months.
  
  
  CONCLUSIONS
  Utilizing both FISH and cytologic morphology, the assessment of Bcl-2/IgH translocation status could contribute to the better detection of minimal bone marrow infiltration and relapse receiving treatment by DLBCL cells.
authors.forename: Yi-Qun
authors.initials: YQ
authors.lastname: Che
authors.forename: Peng
authors.initials: P
authors.lastname: Liu
authors.forename: Yang
authors.initials: Y
authors.lastname: Luo
authors.forename: Di
authors.initials: D
authors.lastname: Shen
authors.forename: Jia-Jie
authors.initials: JJ
authors.lastname: Hao
authors.forename: Lin
authors.initials: L
authors.lastname: Yang
authors.forename: Chang-Gong
authors.initials: CG
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Qi
authors.forename: Ming-Rong
authors.initials: MR
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000737:chemistry / Q000378:metabolism / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000096:biosynthesis* / Q000235:genetics; D008198:Lymph Nodes / Q000737:chemistry / Q000378:metabolism / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D015514:Oncogene Proteins, Fusion / Q000096:biosynthesis* / Q000235:genetics; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000096:biosynthesis* / Q000235:genetics; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D007143:Immunoglobulin Heavy Chains; D015514:Oncogene Proteins, Fusion; D019253:Proto-Oncogene Proteins c-bcl-2