Ferrer Ana, Salaverria Itziar, Bosch Francesc, Villamor Neus, Rozman María, Beà Silvia, Giné Eva, López-Guillermo Armando, Campo Elías, Montserrat Emili
Department of Hematology, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain.
Cancer. 2007 Jun 15;109(12):2473-80. doi: 10.1002/cncr.22715.
The reported incidence of peripheral blood involvement in patients with mantle cell lymphoma (MCL) ranges from 13% to 77%. The aim of the study was to analyze the prevalence and the biologic and clinical significance of leukemic involvement in a series of patients with MCL.
Leukemic expression was assessed by conventional morphology and flow cytometry (FC) in 48 patients. In addition, comparative genomic hybridization (CGH) was performed in 27 patients.
At diagnosis, 44 patients (92%) had evidence of leukemic expression by FC, including 8 patients (17%) without morphologically apparent leukemic involvement. Moreover, a lymphocyte count > or =5 x 10(9)/L was observed in 25 cases (52%). The most frequent imbalances detected by CGH were gains of 3q, 7p, 8q, 9q, 12q, and 13q, and losses of 13q, 1p, 9p, 11q, 10p, 17p, 6q, 8p, and 9q. Using a cutoff of 5 x 10(9)/L lymphocytes, cases with lymphocytosis more frequently presented with gains of 3q (P = .02), losses of 10p (P = .05), a low response rate (P = .04), and a short survival (P = .05).
Leukemic expression at diagnosis detected by FC was found to be highly frequent in this series of patients with MCL. Although morphologically apparent leukemic expression was not associated with specific chromosomal alterations detected by CGH, a lymphocyte count > or =5 x 10(9)/L was correlated with particular genetic abnormalities and a poor outcome.
据报道，套细胞淋巴瘤（MCL）患者外周血受累的发生率在13%至77%之间。本研究的目的是分析一系列MCL患者中白血病受累的患病率及其生物学和临床意义。
采用传统形态学和流式细胞术（FC）对48例患者进行白血病表达评估。此外，对27例患者进行了比较基因组杂交（CGH）。
诊断时，44例（92%）患者通过FC检测有白血病表达证据，其中8例（17%）无形态学明显的白血病受累。此外，25例（52%）患者淋巴细胞计数≥5×10⁹/L。CGH检测到最常见的失衡是3q、7p、8q、9q、12q和13q的增益，以及13q、1p、9p、11q、10p、17p、6q、8p和9q的缺失。以5×10⁹/L淋巴细胞为临界值，淋巴细胞增多的病例更常出现3q增益（P = 0.02）、10p缺失（P = 0.05）、低缓解率（P = 0.04）和短生存期（P = 0.05）。
在这一系列MCL患者中，FC检测到诊断时白血病表达非常常见。虽然形态学明显的白血病表达与CGH检测到的特定染色体改变无关，但淋巴细胞计数≥5×10⁹/L与特定的基因异常和不良预后相关。
