Department of Internal Medicine--Hematooncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Exp Hematol. 2012 Jul;40(7):528-539.e4. doi: 10.1016/j.exphem.2012.02.005. Epub 2012 Feb 27.
Follicular lymphoma (FL) is highly associated with the molecular rearrangement BCL2/IGH. Although BCL2/IGH has been studied many times in follicular lymphoma, its real clinical value remains controversial. In this study, we performed quantitative testing by real-time polymerase chain reaction in 56 FL patients with median follow-up of 44 months (range, 9-102 months); chemotherapy was administered in 52 of 56 cases. Pretreatment numbers of BCL2/IGH varied in wide ranges, with a median of 2947 (range, 0-1,261,013) copies/10(6) cellular equivalent in peripheral blood (PB) and 4650 copies/10(6) cellular equivalent (range, 1-1,056,813) in bone marrow (BM), the difference between PB and BM was significant (p = 0.006). Pretreatment of BCL2/IGH quantities were correlated to clinical parameters (e.g., age, stage, sex, lactate dehydrogenase, B symptoms, grade, bulky disease, chemotherapy regimen) and to progression free-survival. Advanced clinical stage (III and IV) and microscopic BM involvement were significantly associated with higher numbers of BCL2/IGH in PB (p < 0.05) and in BM (p = 0.05), regardless all or newly diagnosed patients were evaluated. High pretreatment burden of BCL2/IGH was associated with significantly shorter progression-free survival; p = 0.003 and p = 0.047 for PB and BM, respectively. In conclusion, pretreatment quantity of BCL2/IGH in PB or BM seems to mirror the extent of disease and can provide an auxiliary prognostic parameter in FL. Our results also support evidence of the negative prognostic value of microscopic BM involvement in FL.
滤泡性淋巴瘤（FL）与 BCL2/IGH 的分子重排高度相关。尽管 BCL2/IGH 在滤泡性淋巴瘤中已经被多次研究，但它的实际临床价值仍存在争议。在这项研究中，我们对 56 例 FL 患者进行了实时聚合酶链反应的定量检测，中位随访时间为 44 个月（范围为 9-102 个月）；56 例中有 52 例接受了化疗。预处理时 BCL2/IGH 的数量差异很大，外周血（PB）的中位数为 2947（范围为 0-1261013）拷贝/10（6）细胞当量，骨髓（BM）为 4650 拷贝/10（6）细胞当量（范围为 1-1056813），PB 和 BM 之间的差异有统计学意义（p = 0.006）。预处理时 BCL2/IGH 数量与临床参数（如年龄、分期、性别、乳酸脱氢酶、B 症状、分级、肿块疾病、化疗方案）和无进展生存相关。晚期临床分期（III 和 IV 期）和骨髓镜下受累与 PB（p < 0.05）和 BM（p = 0.05）中更高数量的 BCL2/IGH 显著相关，无论所有患者还是新诊断的患者都进行了评估。高预处理 BCL2/IGH 负担与无进展生存时间显著缩短相关；PB 和 BM 的 p 值分别为 0.003 和 0.047。总之，PB 或 BM 中的预处理 BCL2/IGH 数量似乎反映了疾病的严重程度，并可为 FL 提供辅助预后参数。我们的结果还支持骨髓镜下受累在 FL 中具有负预后价值的证据。
