Nowotny H, Karlic H, Grüner H, Hirsch J, Vesely M, Nader A, Heinz R
Ludwig Boltzmann Institute for Leukemia Research and Hematology, Hanusch Hospital, Vienna, Austria.
Ann Hematol. 1996 May;72(5):291-301. doi: 10.1007/s002770050175.
Cytogenetics have proved to be a valuable tool for classifying systemic lymphatic neoplasms, as this technique allows different stem line aberrations and clonal developments to be distinguished. This study was designed to analyze how far groups defined according to common cytogenetic features correlated with their position in either the Kiel (KC) or the REAL classification. Cytogenetic analyses were performed on material from 175 patients with lymphoid neoplasms (LN). Samples were prepared from peripheral blood and bone marrow in acute lymphoblastic leukemia (ALL), from bone marrow in multiple myeloma (MM), and from lymph node biopsies in lymphomas. The results of this study support the inclusion of ALL, MM, and extranodal lymphomas into a comprehensive classification, because their chromosomal aberrations were always characteristic for LN. From the cytogenetic point of view, a subgroup of ALL appears as a leukemic manifestation of lymphoblastic lymphoma. MM have structural aberrations of chromosomes 1, 11, and 14 and secondary aberrations of chromosomes 3, 6, 7, 12, 13, and 18, all of which are characteristic for lymphatic disease. The groups with follicle center cell lymphoma and mantle cell lymphoma correlate well with our results both in the low-grade subtype and in the blastic variant type, the majority of cases demonstrating t(14; 18) and its variants and t(11; 14), respectively. In contrast, the group of diffuse large B-cell (DLB) lymphomas proved to be heterogeneous on the basis of our cytogenetic results. Accordingly, we would suggest keeping the immunoblastic lymphoma (IB) subtype defined by the KC. IB demonstrates no stem line aberration in common with any other group and seems to be characterized by stem line aberrations involving chromosomes 3 and 6. As some DLB lymphomas have a t(14;18) or variant translocations involving chromosome 18, they should either be separated as a subgroup or included into the group of follicle center lymphomas.
细胞遗传学已被证明是对系统性淋巴肿瘤进行分类的一项重要工具,因为该技术能够区分不同的干细胞系畸变和克隆发育情况。本研究旨在分析根据常见细胞遗传学特征所定义的组别与它们在基尔(KC)分类或修订的欧美淋巴瘤分类(REAL)中的位置的相关程度。对175例淋巴肿瘤(LN)患者的材料进行了细胞遗传学分析。样本取自急性淋巴细胞白血病(ALL)患者的外周血和骨髓、多发性骨髓瘤(MM)患者的骨髓以及淋巴瘤患者的淋巴结活检组织。本研究结果支持将ALL、MM和结外淋巴瘤纳入一个综合分类中,因为它们的染色体畸变始终是LN的特征性表现。从细胞遗传学角度来看,ALL的一个亚组表现为淋巴母细胞淋巴瘤的白血病表现形式。MM存在1号、11号和14号染色体的结构畸变以及3号、6号、7号、12号、13号和18号染色体的继发性畸变,所有这些都是淋巴疾病的特征性表现。滤泡中心细胞淋巴瘤和套细胞淋巴瘤组在低级别亚型和母细胞变异型中均与我们的结果高度相关,大多数病例分别显示t(14;18)及其变异型和t(11;14)。相比之下,根据我们的细胞遗传学结果,弥漫性大B细胞(DLB)淋巴瘤组被证明具有异质性。因此,我们建议保留KC所定义的免疫母细胞淋巴瘤(IB)亚型。IB未表现出与任何其他组共有的干细胞系畸变,似乎其特征是涉及3号和6号染色体的干细胞系畸变。由于一些DLB淋巴瘤存在t(14;18)或涉及18号染色体的变异易位,它们要么应作为一个亚组分离出来,要么应归入滤泡中心淋巴瘤组。