Sander Sandrine, Bullinger Lars, Leupolt Elke, Benner Axel, Kienle Dirk, Katzenberger Tiemo, Kalla Jörg, Ott German, Müller-Hermelink Hans Konrad, Barth Thomas F E, Möller Peter, Lichter Peter, Döhner Hartmut, Stilgenbauer Stephan
Department of Internal Medicine III, University of Ulm, Robert-Koch-Str. 8, 89081 Ulm, Germany.
Haematologica. 2008 May;93(5):680-7. doi: 10.3324/haematol.12330. Epub 2008 Mar 26.
The genetic hallmark of mantle cell lymphoma is a t(11;14)(q13;q32). However, additional genomic alterations are likely involved in the pathogenesis of this lymphoma.
To determine the incidence and clinical relevance of these aberrations, we analyzed 103 well-characterized samples of mantle cell lymphoma by fluorescence in situ hybridization for the most common recurrent additional genomic findings.
Screening 16 different regions we detected additional genomic aberrations in 92% of the cases of mantle cell lymphoma. Common gains included 3q26, 8q24, 15q23, 7p15, and common losses 13q14, 11q22-q23, 9p21, 1p22, 17p13, 6q27, and 8p22. Deletions 8p22, 9p21, 13q14, and gain of 7p15 were associated with evidence of clonal heterogeneity. While there was no correlation of additional genomic aberrations and VH-mutation status, gain of 15q23 and deletion 6q27 were associated with lower disease stage (p=0.01 and p=0.04, respectively). Patients with deletion 13q14 had shorter overall survival times (p=0.01), and there was a strong trend towards inferior outcome in patients with deletion 9p21 (p=0.07). In multivariable analysis, loss of 13q14 and an International Prognosis Index score >/= 3 turned out to be significantly associated with inferior clinical outcome (p=0.002 and p<0.001, respectively).
The comprehensive analysis of additional genomic aberrations in mantle cell lymphoma provided further evidence for the prognostic relevance of loss of 13q14, which warrants evaluation within prospective trials. Furthermore, our analysis gave novel insights into the pathogenesis of mantle cell lymphoma with regard to the detection of clonal heterogeneity, possibly indicating clonal evolution in this type of lymphoma.
套细胞淋巴瘤的基因特征是t(11;14)(q13;q32)。然而,其他基因组改变可能也参与了这种淋巴瘤的发病机制。
为了确定这些畸变的发生率及临床相关性,我们通过荧光原位杂交技术,对103例特征明确的套细胞淋巴瘤样本进行分析,以寻找最常见的复发性额外基因组改变。
在筛查16个不同区域时,我们在92%的套细胞淋巴瘤病例中检测到了额外的基因组畸变。常见的扩增区域包括3q26、8q24、15q23、7p15,常见的缺失区域包括13q14、11q22 - q23、9p21、1p22、17p13、6q27和8p22。8p22、9p21、13q14的缺失以及7p15的扩增与克隆异质性证据相关。虽然额外的基因组畸变与VH突变状态无相关性,但15q23的扩增和6q27的缺失与较低的疾病分期相关(分别为p = 0.01和p = 0.04)。13q14缺失的患者总生存时间较短(p = 0.01),9p21缺失的患者有预后较差的强烈趋势(p = 0.07)。在多变量分析中,13q14缺失和国际预后指数评分≥3与较差的临床结局显著相关(分别为p = 0.002和p < 0.001)。
对套细胞淋巴瘤额外基因组畸变的综合分析为13q14缺失的预后相关性提供了进一步证据,这值得在前瞻性试验中进行评估。此外,我们的分析在克隆异质性检测方面为套细胞淋巴瘤的发病机制提供了新见解,可能表明这种类型淋巴瘤存在克隆进化。