Mandigers C M P W, Meijerink J P P, van 't Veer M B, Mensink E J B M, Raemaekers J M M
Department of Hematology, University Medical Center Nijmegen, Nijmegen, The Netherlands.
Ann Hematol. 2003 Dec;82(12):743-9. doi: 10.1007/s00277-003-0762-6. Epub 2003 Sep 25.
In follicular lymphoma the t(14;18) might be useful as a tumor marker in predicting the quality of the response to treatment. We investigated whether analyzing numbers of t(14;18)-positive cells in peripheral blood correlated with remission status in individual patients receiving a variety of treatments. Numbers of circulating t(14;18)-positive cells were determined by real-time polymerase chain reaction (PCR) technique. Disease parameters and response to treatment were related to the pre- and post-treatment numbers of circulating t(14;18)-positive cells for 53 follicular lymphoma patients. In these 53 patients, 70 treatment episodes were investigated. A content of more than 328 t(14;18)-positive cells per 75,000 cells prior to therapy correlated with the more advanced stage IV disease ( P=0.01), bone marrow involvement ( P<0.01), and overt leukemic lymphoma ( P=0.04). Therapy episodes that cleared circulation from t(14;18)-positive cells with more than one log resulted in a significantly longer progression-free survival than treatment episodes with less than one log decline (26 versus 12 months, respectively) ( P<0.01). After first-line treatment episodes, numbers of circulating t(14;18)-positive cells declined in fairly all cases, irrespective of the clinical response. However, for second or later lines of treatment, declining numbers of lymphoma cells correlated with a clinical remission, whereas increasing numbers of lymphoma cells were associated with clinically stable or progressive disease. From this, we conclude that quantitation of circulating t(14;18)-positive cells in peripheral blood is of only limited clinical significance in predicting treatment efficacy for the individual follicular lymphoma patient.
在滤泡性淋巴瘤中，t(14;18)可能作为一种肿瘤标志物用于预测治疗反应的质量。我们研究了分析接受各种治疗的个体患者外周血中t(14;18)阳性细胞数量是否与缓解状态相关。通过实时聚合酶链反应（PCR）技术测定循环中t(14;18)阳性细胞的数量。对53例滤泡性淋巴瘤患者治疗前和治疗后循环中t(14;18)阳性细胞数量与疾病参数及治疗反应进行了相关性分析。在这53例患者中，共调查了70个治疗疗程。治疗前每75,000个细胞中t(14;18)阳性细胞含量超过328个与更晚期的IV期疾病（P = 0.01）、骨髓受累（P < 0.01）及明显的白血病性淋巴瘤（P = 0.04）相关。t(14;18)阳性细胞循环清除超过一个对数级的治疗疗程导致无进展生存期显著长于清除少于一个对数级的治疗疗程（分别为26个月和12个月）（P < 0.01）。一线治疗疗程后，无论临床反应如何，几乎所有病例循环中t(14;18)阳性细胞数量均下降。然而，对于二线或后续治疗，淋巴瘤细胞数量下降与临床缓解相关，而淋巴瘤细胞数量增加与临床稳定或疾病进展相关。由此，我们得出结论，外周血中循环t(14;18)阳性细胞的定量分析在预测个体滤泡性淋巴瘤患者的治疗疗效方面临床意义有限。
