Wu Yafang, Xue Yongquan, Chen Suning, Yao Li, Jiang Hui, Zhang Jun, Shen Juan, Pan Jinlan, Wang Yong, Bai Shuxiao
The First Affiliated Hospital, Soochow University, Jiangsu Institute of Hematology, Suzhou, Jiangsu, 215006 P.R.China.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2010 Feb;27(1):86-91. doi: 10.3760/cma.j.issn.1003-9406.2010.01.019.
To investigate whether CpG-oligodeoxynucleotide (CpG-ODN) can improve the detection rate of the karyotypic abnormalities in chronic lymphocytic leukemia (CLL).
The bone marrow (BM) or peripheral blood (PB) cells from 57 cases of CLL were collected and cultured with CpG-ODN DSP30+interleukin-2 (IL-2), phytohemagglutinin (PHA), pokeweed (PWM) or IL-2, respectively. Five days later cells were harvested for chromosome preparation. Karyotypic analysis was done using R banding technique. Panel fluorescence in situ hybridization (FISH) was carried out on 19 cases of CLL with normal karyotypes using the following probes: Cen12, D13S25, Rb1, ATM, p53, MYB and IgH. Genomic DNA from 21 cases of them was extracted from BM or PB leukocytes. The immunoglobulin variable heavy chain (IgVH) was amplified by polymerase chain reaction (PCR) and sequenced. CD38 and ZAP70 expressions in the leukemic cells were determined by flow cytometry (FCM).
The detection rate of karyotypic abnormalities in the CpG-ODN+IL-2 group (43.85%) was obviously higher than that in the PHA (15.09%), PWM (17.31%) and IL-2 (3.13%) groups (P<0.01). Fifty-two types of karyotypic abnormalities were found. Among them, trisomy12 (+12) or +12 with other abnormalities were the most common, while translocations were the most frequent structural abnormalities including 3 unbalanced and 11 balanced translocations, among them 7 had rearrangements involving 14q32. Thirteen cases showed one or more abnormalities on FISH including trisomy 12 and p53 deletion each in one case, IgH rearrangement and partial deletion each in one case, 13q14.3 deletion in 11 cases of which 5 cases also had Rb1 deletion, 1 case had Rb1 partial deletion. No case with ATM or MYB deletions was found. PCR detected IgVH mutations in 10/21 cases. FCM showed 10/45 cases were CD38 positive, but 35 /45 were CD38 negative, 11/27 cases expressed ZAP70, but 16/27 did not. Among the 26 cases examined for CD38 and ZAP70 expressions simultaneously, 5 cases were CD38+ZAP70+, 13 were CD38-ZAP70-, 6 were CD38-ZAP70+, and 2 were CD38+ZAP70-, respectively. Statistic analysis showed a correlation between complex karyotype and IgVH without mutation, but no association between karyotype and CD38 or ZAP70 expression was observed.
CpG-ODN immunostimulation can obviously raise the detection rate of abnormal karyotypes, especially translocations in CLL. FISH is an important complement to conventional karyotypic analysis. The combination of both methods can provide more comprehensive genetic information for CLL.
探讨CpG-寡脱氧核苷酸(CpG-ODN)能否提高慢性淋巴细胞白血病(CLL)核型异常的检出率。
收集57例CLL患者的骨髓(BM)或外周血(PB)细胞,分别用CpG-ODN DSP30+白细胞介素-2(IL-2)、植物血凝素(PHA)、商陆(PWM)或IL-2进行培养。5天后收获细胞制备染色体。采用R显带技术进行核型分析。对19例核型正常的CLL患者,使用以下探针进行荧光原位杂交(FISH)检测:Cen12、D13S25、Rb1、ATM、p53、MYB和IgH。其中21例患者的基因组DNA从BM或PB白细胞中提取。通过聚合酶链反应(PCR)扩增免疫球蛋白可变重链(IgVH)并进行测序。采用流式细胞术(FCM)检测白血病细胞中CD38和ZAP70的表达。
CpG-ODN+IL-2组核型异常检出率(43.85%)明显高于PHA组(15.09%)、PWM组(17.31%)和IL-2组(3.13%)(P<0.01)。共发现52种核型异常。其中,三体12(+12)或伴有其他异常的+12最为常见,而染色体易位是最常见的结构异常,包括3种不平衡易位和11种平衡易位,其中7种涉及14q32重排。13例FISH检测显示一种或多种异常,包括1例三体12和1例p53缺失,1例IgH重排和1例部分缺失,11例13q14.3缺失,其中5例同时伴有Rb1缺失,1例Rb1部分缺失。未发现ATM或MYB缺失病例。PCR检测发现21例中有10例存在IgVH突变。FCM显示45例中有10例CD38阳性,但35例CD38阴性,27例中有11例表达ZAP70,但16例不表达。在同时检测CD38和ZAP70表达的26例中,5例为CD38+ZAP70+,13例为CD38-ZAP70-,6例为CD38-ZAP70+,2例为CD38+ZAP70-。统计学分析显示复杂核型与无突变的IgVH之间存在相关性,但未观察到核型与CD38或ZAP70表达之间的关联。
CpG-ODN免疫刺激可明显提高CLL核型异常尤其是易位的检出率。FISH是传统核型分析的重要补充。两种方法联合应用可为CLL提供更全面的遗传信息。