Portada Simposios - Supplements - Haematologica

XLII Reunión Nacional de la AEHH y XVI Congreso de la SETH. Simposios
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CYTOGENETIC AND MOLECULAR
CYTOGENETIC FEATURES
OF NON-HODGKIN’S LYMPHOMA
OF LYMPHOID FOLLICLE ORIGIN
(FOLLICLE CENTRE CELL
AND MANTLE CELL)
A. CUNEO, R. BIGONI, M. GRAZIA ROBERTI,
A. BARDI, G. MATTEO RIGOLIN, P. AGOSTINI,
R. MILANI, F. CAVAZZINI, C. DE ANGELI
AND G. CASTOLDI
Dipartimento di Scienze Biomediche e Terapie Avanzate.
Sezione di Ematologia. Università di Ferrara, Via Savonarola,
9 – 44100 Ferrara, Italy
Introduction
A number of recurrent chromosome translocations
have been detected in lymphoid neoplasias, well characterized
by molecular genetic studies, highlighting
fundamental mechanisms of neoplastic transformation.
Some translocations showed an association
with specific clinicopathologic types: with few exceptions,
the t(14;18) is a diagnostic feature of follicle
centre cell lymphoma; the t(11;14)(q13;q32) indicates
the origin of lymphoma cells from the follicle
mantle, the t(8;14)(q24;q32) identifies Burkitt’s
lymphoma and related disorders, the t(3;V)(q27;V)
defines a genetically distinct subgroup of diffuse large
cell lymphoma, the t(2;5)(p23;q35) and the related
NPM/ALK fusion protein is the hallmark of
CD30+ anaplastic large cell lymphoma.
A growing body of evidence has accumulated over
the last 10 years suggesting that so-called “secondary”
chromosome changes play an important role
in determining the clinical phenotype in lymphoid tumors
1-3 . Additional chromosome changes were
shown to consist mostly of unbalanced rearrangements,
leading to DNA gain or loss, and the cytogenetic
profile of each form of lymphoma was found to
vary according to the primary anomaly defining the
stemline. Thus, while trisomy 7 and trisomy 12 occurred
at a relatively high incidence in non-Hodgkin’s
lymphoma (NHL) of follicle centre cell lineage carrying
the t(14;18), monosomy 13, –Y, 6q– were listed
among the most frequent aberrations occurring in
addition to the 11;14 translocation in MCL.
The development of molecular cytogenetic techniques,
i.e. fluorescence in situ hybridization (FISH)
and comparative genomic hybridization (CGH) allowed
for a more definite assessment of the cytogentic
profile of NHL.
The significance of primary and secondary chromosome
lesions in follicle centre cell lymphoma
(FCCL) and mantle cell lymphoma (MCL) are summarized
in this report, with reference to the correlation
with clinicopathological features.
Follicle centre cell lymphoma (FCCL)
FCCL accounts for as many as 40 % of all NHL in
western countries.
This lymphoid tumor consists of a proliferation of
centrocytes/centroblasts unable to progress through
the germinal centre, harbouring somatic hypermutation
of the IgV genes and ongoing mutations (antigen
driven stimulation). The immunophenotype is
typically pan-B+; CD10+/–; CD5–; sIg+. The primary
chromosomal aberration is the t(14;18)(q32,q21)
fusing the Ig heavy chain gene and the BCL2 gene.
This chromosomal rearrangement can be detected
in 70-80 % of the cases by conventional cytogenetic
analysis, by southern blotting and by FISH.
In most studies evidence was provided that this
chromosomal rearrangement does not have an impact
on prognosis 1,4 . A study found a correlation
between prognosis and the breakpoint location in
the BCL2 region, with a 95 %, 76 % and 57 %
three-year failure free survival in those cases with
mbr, MBR and germline BCL2 configuration, respectively
5 .