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Network properties derived from deep sequencing of human B-cell receptor repertoires delineate B-cell populations. Genome Res 2013; 23:1874-84. [PMID: 23742949 PMCID: PMC3814887 DOI: 10.1101/gr.154815.113] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The adaptive immune response selectively expands B- and T-cell clones following antigen recognition by B- and T-cell receptors (BCR and TCR), respectively. Next-generation sequencing is a powerful tool for dissecting the BCR and TCR populations at high resolution, but robust computational analyses are required to interpret such sequencing. Here, we develop a novel computational approach for BCR repertoire analysis using established next-generation sequencing methods coupled with network construction and population analysis. BCR sequences organize into networks based on sequence diversity, with differences in network connectivity clearly distinguishing between diverse repertoires of healthy individuals and clonally expanded repertoires from individuals with chronic lymphocytic leukemia (CLL) and other clonal blood disorders. Network population measures defined by the Gini Index and cluster sizes quantify the BCR clonality status and are robust to sampling and sequencing depths. BCR network analysis therefore allows the direct and quantifiable comparison of BCR repertoires between samples and intra-individual population changes between temporal or spatially separated samples and over the course of therapy.
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52
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Porwit A. Immunophenotyping of selected hematologic disorders - focus on lymphoproliferative disorders with more than one malignant cell population. Int J Lab Hematol 2013; 35:275-82. [DOI: 10.1111/ijlh.12080] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 02/14/2013] [Indexed: 11/30/2022]
Affiliation(s)
- A. Porwit
- Department of Pathobiology and Laboratory Medicine; University of Toronto; University Health Network; Toronto ON Canada
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53
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Visco C, Moretta F, Falisi E, Facco M, Maura F, Novella E, Nichele I, Finotto S, Giaretta I, Ave E, Perbellini O, Guercini N, Scupoli MT, Trentin L, Trimarco V, Neri A, Semenzato G, Rodeghiero F, Pizzolo G, Ambrosetti A. Double productive immunoglobulin sequence rearrangements in patients with chronic lymphocytic leukemia. Am J Hematol 2013; 88:277-82. [PMID: 23450508 DOI: 10.1002/ajh.23396] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 01/10/2013] [Accepted: 01/11/2013] [Indexed: 11/06/2022]
Abstract
The immunoglobulin heavy chain variable (IGHV) gene mutational status represents a major prognostic marker in chronic lymphocytic leukemia (CLL). Usually, the prognostic implications of IGHV gene analysis can be reliably ascertained but, occasionally, double productive rearrangements have been detected. Clinical presentation and biological features of such cases are unknown. Sixty patients with morphologically and phenotypically monoclonal CLL but double productive IGHV rearrangements were retrospectively identified by mRNA analysis from three Hematology Institutions. Clinical and biological features and survival of these 60 patients were compared with a control group of patients with CLL and single IGHV rearrangement. A prospective registry was used to assess the epidemiology of double productive IGHV among incidental patients with CLL. Using standard criteria to define IGHV-mutated (M) or unmutated (U) cases, 39 of the 60 patients (65%) with double productive IGHV rearrangement had concordant status (23 MM, 16 UU), while 21 (35%) had discordant IGHV status. As compared with M patients, the MM ones had lower CD38 expression, more favorable cytogenetics and more indolent clinical behavior. Cases with UU had similar characteristics of U patients. Discordant cases presented with adverse prognostic features and had an aggressive clinical behavior requiring early treatment, similar to U patients. The prevalence of double IGHV was 3.1%. Patients with CLL with double concordant mutational status (MM or UU) have a clinical course similar to that of the corresponding single IGHV status, while those exhibiting discordant status represent a high risk population. This may help correct stratification within clinical trials.
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Affiliation(s)
- Carlo Visco
- Department of Hematology S. Bortolo Hospital; Vicenza Italy
| | - Francesca Moretta
- Hematology Section, Department of Medicine; University of Verona; Italy
| | - Erika Falisi
- Department of Hematology S. Bortolo Hospital; Vicenza Italy
| | - Monica Facco
- Department of Medicine, Hematology and Clinical Immunology Branch; Padua University School of Medicine; Padova Italy
| | - Francesco Maura
- Department of Medical Sciences and Hematology-CTMO; University of Milano; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano Italy
| | | | - Ilaria Nichele
- Department of Hematology S. Bortolo Hospital; Vicenza Italy
| | - Silvia Finotto
- Department of Hematology S. Bortolo Hospital; Vicenza Italy
| | | | - Elisa Ave
- Department of Medicine, Hematology and Clinical Immunology Branch; Padua University School of Medicine; Padova Italy
| | - Omar Perbellini
- Hematology Section, Department of Medicine; University of Verona; Italy
| | | | | | - Livio Trentin
- Department of Medicine, Hematology and Clinical Immunology Branch; Padua University School of Medicine; Padova Italy
| | - Valentina Trimarco
- Department of Medicine, Hematology and Clinical Immunology Branch; Padua University School of Medicine; Padova Italy
| | - Antonino Neri
- Department of Medical Sciences and Hematology-CTMO; University of Milano; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano Italy
| | - Gianpietro Semenzato
- Department of Medicine, Hematology and Clinical Immunology Branch; Padua University School of Medicine; Padova Italy
| | | | - Giovanni Pizzolo
- Hematology Section, Department of Medicine; University of Verona; Italy
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Morikawa K, Tsuji T, Yamasaki H, Toyozumi Y, Arima N, Ohshima K, Tsuda H. Central nervous system lymphoma newly developed 12 years after remission of an ocular adnexal lymphoma. Acta Haematol 2013; 130:247-50. [PMID: 23860499 DOI: 10.1159/000350485] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 02/28/2013] [Indexed: 11/19/2022]
Abstract
Recurrence of non-Hodgkin's lymphoma more than 5 years after the initial diagnosis is rare. When late relapse occurs, it is difficult to determine whether it is a true recurrence or a new lesion. We experienced a case of an 81-year-old woman who developed central nervous system (CNS) lymphoma 12 years after remission of ocular adnexal lymphoma. Both showed the histology of diffuse large B-cell lymphoma. To elucidate whether the CNS lymphoma was clonally related to the first lymphoma, rearrangement of the immunoglobulin heavy chain genes of each lymphoma was studied using a polymerase chain reaction-based method. The results revealed that the sizes of the amplified products of the rearranged regions from the two lymphomas were different. This suggested different clonal origins of the lymphomas. It is clinically important to determine the origin of a second neoplasm because patients with a clonally related second lymphoma are usually treated with more intensive regimens, while those with a clonally unrelated lymphoma receive standard first-line therapy. The present case shows that, in the case of recurrent non-Hodgkin's lymphoma, not only histological confirmation but also genetic assessment is important to clarify the origin of the second lymphoma.
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Affiliation(s)
- Keiko Morikawa
- Department of Hematology and Oncology, Kumamoto City Hospital, Kumamoto, Japan
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55
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Rodríguez AE, Hernández JÁ, Benito R, Gutiérrez NC, García JL, Hernández-Sánchez M, Risueño A, Sarasquete ME, Fermiñán E, Fisac R, de Coca AG, Martín-Núñez G, de las Heras N, Recio I, Gutiérrez O, De Las Rivas J, González M, Hernández-Rivas JM. Molecular characterization of chronic lymphocytic leukemia patients with a high number of losses in 13q14. PLoS One 2012; 7:e48485. [PMID: 23152777 PMCID: PMC3496725 DOI: 10.1371/journal.pone.0048485] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 10/02/2012] [Indexed: 12/22/2022] Open
Abstract
Background Patients with chronic lymphocytic leukemia and 13q deletion as their only FISH abnormality could have a different outcome depending on the number of cells displaying this aberration. Thus, cases with a high number of 13q- cells (13q-H) had both shorter overall survival and time to first therapy. The goal of the study was to analyze the genetic profile of 13q-H patients. Design and Methods: A total of 102 samples were studied, 32 of which served as a validation cohort and five were healthy donors. Results Chronic lymphocytic leukemia patients with higher percentages of 13q- cells (>80%) showed a different level of gene expression as compared to patients with lower percentages (<80%, 13q-L). This deregulation affected genes involved in apoptosis and proliferation (BCR and NFkB signaling), leading to increased proliferation and decreased apoptosis in 13q-H patients. Deregulation of several microRNAs, such as miR-15a, miR-155, miR-29a and miR-223, was also observed in these patients. In addition, our study also suggests that the gene expression pattern of 13q-H cases could be similar to the patients with 11q- or 17p-. Conclusions This study provides new evidence regarding the heterogeneity of 13q deletion in chronic lymphocytic leukemia patients, showing that apoptosis, proliferation as well as miRNA regulation are involved in cases with higher percentages of 13q- cells.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Alleles
- Case-Control Studies
- Chromosome Deletion
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 13
- Chromosomes, Human, Pair 17
- Cluster Analysis
- Female
- Gene Expression Profiling
- Gene Expression Regulation, Leukemic
- Humans
- Immunoglobulin Heavy Chains/genetics
- Immunoglobulin Variable Region/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Male
- MicroRNAs/genetics
- MicroRNAs/metabolism
- Middle Aged
- Mutation
- Signal Transduction
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Affiliation(s)
- Ana Eugenia Rodríguez
- IBSAL,IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
| | | | - Rocío Benito
- IBSAL,IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
| | - Norma C. Gutiérrez
- Servicio de Hematología, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - Juan Luis García
- Instituto de Estudios de Ciencias de la Salud de Castilla y León, (IECSCYL)–HUSAL, Castilla y León, Spain
| | - María Hernández-Sánchez
- IBSAL,IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
| | - Alberto Risueño
- Grupo de Bioinformática y Genómica Funcional, IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
- Celgene Institute for Translational Research Europe (CITRE), Sevilla, Spain
| | - M. Eugenia Sarasquete
- Servicio de Hematología, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - Encarna Fermiñán
- Unidad de Genómica, IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
| | - Rosa Fisac
- Servicio de Hematología, Hospital General de Segovia, Segovia, Spain
| | | | | | | | - Isabel Recio
- Servicio de Hematología, Hospital Nuestra Señora de Sonsoles, Ávila, Spain
| | - Oliver Gutiérrez
- Servicio de Hematología, Hospital del Río Hortega, Valladolid, Spain
| | - Javier De Las Rivas
- Grupo de Bioinformática y Genómica Funcional, IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
| | - Marcos González
- IBSAL,IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
- Servicio de Hematología, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - Jesús M. Hernández-Rivas
- IBSAL,IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
- Servicio de Hematología, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
- * E-mail:
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EuroClonality/BIOMED-2 guidelines for interpretation and reporting of Ig/TCR clonality testing in suspected lymphoproliferations. Leukemia 2012; 26:2159-71. [PMID: 22918122 PMCID: PMC3469789 DOI: 10.1038/leu.2012.246] [Citation(s) in RCA: 340] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PCR-based immunoglobulin (Ig)/T-cell receptor (TCR) clonality testing in suspected lymphoproliferations has largely been standardized and has consequently become technically feasible in a routine diagnostic setting. Standardization of the pre-analytical and post-analytical phases is now essential to prevent misinterpretation and incorrect conclusions derived from clonality data. As clonality testing is not a quantitative assay, but rather concerns recognition of molecular patterns, guidelines for reliable interpretation and reporting are mandatory. Here, the EuroClonality (BIOMED-2) consortium summarizes important pre- and post-analytical aspects of clonality testing, provides guidelines for interpretation of clonality testing results, and presents a uniform way to report the results of the Ig/TCR assays. Starting from an immunobiological concept, two levels to report Ig/TCR profiles are discerned: the technical description of individual (multiplex) PCR reactions and the overall molecular conclusion for B and T cells. Collectively, the EuroClonality (BIOMED-2) guidelines and consensus reporting system should help to improve the general performance level of clonality assessment and interpretation, which will directly impact on routine clinical management (standardized best-practice) in patients with suspected lymphoproliferations.
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57
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Abstract
Recent genomic studies have outlined a landscape of recurrent alterations within some subtypes of lymphoid cancer. Yet, the timing and cellular contexts during which these alterations occur (ie, the molecular ontogeny) remain poorly understood. Lymphoid malignancies offer an exceptional opportunity to delineate the ontogeny of somatic alterations, as lymphocyte differentiation absolutely requires the introduction of indelible genetic rearrangements at antigen receptor loci during specific stages of maturation. We review competing models of lymphomagenesis and highlight evolving evidence that somatic alterations in uncommitted hematopoietic progenitors contribute to some mature lymphoid neoplasms. These progenitors could serve as reservoirs for further clonal evolution and thereby contribute to therapeutic resistance, tumor relapse, and the development of second hematologic malignancies. Defining the pathways that are dysregulated within early progenitors and the ontogeny of subsequent alterations that contribute to lymphoid transformation could establish novel therapeutic targets across a variety of hematologic malignancies and even guide avenues for future preventive strategies.
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58
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Nicholson KM, Patel KP, Duvic M, Prieto VG, Tetzlaff MT. Bi-clonal, multifocal primary cutaneous marginal zone B-cell lymphoma: report of a case and review of the literature. J Cutan Pathol 2012; 39:866-71. [DOI: 10.1111/j.1600-0560.2012.01954.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Revised: 03/26/2012] [Accepted: 04/08/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Kimberly M. Nicholson
- Department of Pathology, Division of Dermatopathology; The University of Texas MD Anderson Cancer Center; Houston; TX; USA
| | - Keyur P. Patel
- Department of Hematopathology; The University of Texas MD Anderson Cancer Center; Houston; TX; USA
| | - Madeleine Duvic
- Department of Dermatology; The University of Texas MD Anderson Cancer Center; Houston; TX; USA
| | | | - Michael T. Tetzlaff
- Department of Pathology, Division of Dermatopathology; The University of Texas MD Anderson Cancer Center; Houston; TX; USA
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59
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Frequency of additional clonal populations detected by high sensitivity flow cytometry in patients with hairy cell leukemia. J Hematop 2012. [DOI: 10.1007/s12308-012-0137-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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60
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Papathomas TG, Venizelos I, Dunphy CH, Said JW, Wang ML, Campo E, Swerdlow SH, Chan JC, Bueso-Ramos CE, Weisenburger DD, Medeiros LJ, Young KH. Mantle cell lymphoma as a component of composite lymphoma: clinicopathologic parameters and biologic implications. Hum Pathol 2012; 43:467-80. [PMID: 22221705 DOI: 10.1016/j.humpath.2011.08.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2011] [Revised: 08/30/2011] [Accepted: 08/31/2011] [Indexed: 12/22/2022]
Abstract
Composite lymphoma is a rare circumstance in which 2 or more distinct types of lymphoma occur in a single anatomical location. Although composite lymphoma has been increasingly identified with the advent of molecular genetic techniques, this topic has only rarely been a specific focus of the medical scientific literature. In this review, we focus on mantle cell lymphoma occurring as a major pathologic component of composite lymphoma and emphasize the clinicopathologic features of these tumors and associated biologic implications. To date, 26 cases of composite lymphoma including a component of mantle cell lymphoma have been previously published. Issues of clonal relatedness between the individual lymphoma components and emerging biologic implications as well as potential diagnostic pitfalls are evaluated.
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Affiliation(s)
- Thomas G Papathomas
- Department of Pathology, Hippokration General Hospital of Thessaloniki, 54642 Thessaloniki, Greece
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61
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62
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Kikushige Y, Ishikawa F, Miyamoto T, Shima T, Urata S, Yoshimoto G, Mori Y, Iino T, Yamauchi T, Eto T, Niiro H, Iwasaki H, Takenaka K, Akashi K. Self-renewing hematopoietic stem cell is the primary target in pathogenesis of human chronic lymphocytic leukemia. Cancer Cell 2011; 20:246-59. [PMID: 21840488 DOI: 10.1016/j.ccr.2011.06.029] [Citation(s) in RCA: 218] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 05/27/2011] [Accepted: 06/30/2011] [Indexed: 10/17/2022]
Abstract
We report here that in chronic lymphocytic leukemia (CLL), the propensity to generate clonal B cells has been acquired already at the hematopoietic stem cell (HSC) stage. HSCs purified from patients with CLL displayed lymphoid-lineage gene priming and produced a high number of polyclonal B cell progenitors. Strikingly, their maturation into B cells was restricted always to mono- or oligo-clones with CLL-like phenotype in xenogeneic recipients. These B cell clones were independent of the original CLL clones because they had their own immunoglobulin VDJ genes. Furthermore, they used preferentially VH genes frequently used in human CLL, presumably reflecting the role of B cell receptor signaling in clonal selection. These data suggest that HSCs can be involved in leukemogenesis even in mature lymphoid tumors.
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Affiliation(s)
- Yoshikane Kikushige
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka 812-8582, Japan
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63
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Immunoglobulin sequence analysis and prognostication in CLL: guidelines from the ERIC review board for reliable interpretation of problematic cases. Leukemia 2011; 25:979-84. [PMID: 21455216 DOI: 10.1038/leu.2011.49] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Immunoglobulin gene sequence analysis is widely utilized for prognostication in chronic lymphocytic leukemia (CLL) and the definition of standardized procedures has allowed reliable and reproducible results. Occasionally, a straightforward interpretation of the sequences is not possible because of the so-called 'problematic sequences' that do not fit the 'classic' interpretation and pose scientific questions at the cross-road between hematology and immunology. Thanks to a dedicated effort within the European Research Initiative on CLL (ERIC), we have now the possibility to present such cases, offer a scientific explanation and propose recommendations in terms of prognostication.
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64
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Owen RG, Bynoe AG, Varghese A, de Tute R, Rawstron AC. Heterogeneity of Histological Transformation Events in Waldenström's Macroglobulinemia (WM) and Related Disorders. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2011; 11:176-9. [DOI: 10.3816/clml.2011.n.042] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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65
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Matutes E, Attygalle A, Wotherspoon A, Catovsky D. Diagnostic issues in chronic lymphocytic leukaemia (CLL). Best Pract Res Clin Haematol 2011; 23:3-20. [PMID: 20620967 DOI: 10.1016/j.beha.2010.01.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The diagnosis of chronic lymphocytic leukaemia (CLL) is based on clinical and laboratory features. Morphology and immunophenotype are the initial diagnostic investigations. In atypical cases, these tests should be complemented with molecular genetics and/or histology to exclude other B-cell disorders of small lymphocytes. Morphologically, CLL can be classified into typical and atypical. Immunophenotyping is the only method that can establish or confirm the diagnosis as CLL lymphocytes have a distinct immunophenotypic signature. A scoring system compounding the results with a set of markers allows firming up the diagnosis. Other immunological markers such as CD38 and ZAP-70 have an important prognostic impact. Fluorescence in situ hybridization (FISH) analysis, chiefly by detecting 17p (TP53 locus) and 11q (ATM) deletions and mutational status of the IgVH gene, also provides prognostic information and may determine the type of therapy. In atypical CLL, histology and/or molecular genetics may be required to exclude other B-cell disorders.
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Affiliation(s)
- Estella Matutes
- Section of Haemato-Oncology Department, The Royal Marsden Hospital and Institute of Cancer Research, Fulham Road, London SW3 6JJ, UK.
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66
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Xu W, Wang YH, Fan L, Fang C, Zhu DX, Wang DM, Qiao C, Wu YJ, Li JY. Prognostic significance of serum immunoglobulin paraprotein in patients with chronic lymphocytic leukemia. Leuk Res 2011; 35:1060-5. [PMID: 21208658 DOI: 10.1016/j.leukres.2010.12.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Revised: 11/16/2010] [Accepted: 12/06/2010] [Indexed: 11/18/2022]
Abstract
The aim of this study was to explore the clinical and other associated laboratory features of chronic lymphocytic leukemia (CLL) patients with immunoglobulin (Ig) paraproteinemia. Serum protein electrophoresis (SPE) and immunofixation electrophoresis (IFE) were performed to measure serum Ig paraprotein. The correlations between serum Ig paraprotein and other prognostic factors were analyzed. Univariate and multivariate Cox regression analyses were used to assess associations between survival time and potential risk factors. In 133 Chinese CLL patients, 27 (20.3%) patients occurred Ig paraproteinemia at diagnosis. According to the correlation analysis, advanced Binet stage (r=0.314, P<0.001), direct antiglobulin test (DAT)-positive (r=0.366, P<0.001), high level of serum β2-microglobulin (β2-MG) (r=0.296, P=0.001) and thymidine kinase (TK) 1 (r=0.227, P=0.037), unmutated immunoglobulin heavy chain variable gene (IGHV) status (r=0.284, P=0.002), ZAP-70-positive (r=0.305, P=0.001), CD38-positive (r=0.284, P=0.002), and cytogenetic abnormalities of del(17p13) or del(11q22.3) (r=0.208, P=0.032) emerged as factors significantly related to the occurrence of Ig paraproteinemia. Survival analysis showed that the patients with Ig paraproteinemia had significantly shorter survival times than the patients without serum Ig paraprotein (P=0.013). Binet stage (P=0.028), high levels of lactate dehydrogenase (LDH) (P=0.004), IgG paraproteinemia (P=0.048), IgM paraproteinemia (P=0.001), ZAP-70-positive (P=0.003), DAT-positive (P=0.013), unmutated IGHV status (P=0.009), and del(17p13) (P=0.001) were the adverse factors in determining overall survival (OS). Del(17p13) (P=0.006), ZAP-70 (P=0.030), and IgM paraproteinemia (P=0.040) were the variables strongly associated with OS by multivariate Cox regression analysis. It was showed that serum Ig paraprotein might be applied for the assessment of prognosis in patients with CLL.
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Affiliation(s)
- Wei Xu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
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67
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Immunohistochemical study of expression of immunoglobulins in canine B-cell lymphomas. Pol J Vet Sci 2010; 13:623-8. [DOI: 10.2478/v10181-010-0004-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Immunohistochemical study of expression of immunoglobulins in canine B-cell lymphomasNineteen canine lymphomas were included in this study. Tumors were classified according to the updated Kiel classification adapted for canine lymphomas by Fournel-Fleury et al. Immunoglobulin light chains (κ and λ) and IgM and IgG expression were determined by immunohistochemical method. In all examined cases neoplastic cells were positive for one of the immunoglobulin light chains. Expression of λ light chains and κ light chains was observed in 18/19 and 1/19 tumors, respectively. In the majority of neoplastic cells in each examined specimen this reaction had a membranous pattern (sκ/sλ). In all examined cases the presence of immunoglobulin light chains was also observed in the cytoplasm of some neoplastic cells (cκ/cλ). These cells were usally rare and never constituted a dominant population. The expression of immunoglobulin was found in 13/19 cases. Most lymphomas were sIgM positive (11/13 cases). In one case expression of IgG was found, and in another lymphoma two populations of neoplastic cells with different expression of examined immunoglobulins (cells with IgM+and IgG+phenotypes) were observed. The reaction also had a membranous pattern. The cells containing cytoplasmic immunoglobulins were rare, and in most cases were of the same type as the surface immunoglobulins. Our study has confirmed that canine lymphomas are a monoclonal proliferation of B-cells usually expressing immunoglobulin λ light chains and that the vast majority of tumors deriving from B-cells express IgM. Our study also indicates a possibility of occurence of biclonal lymphomas in canine species.
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68
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Perdigão J, Alaiz H, Lúcio P, Gameiro P, Sebastião M, Neto L, Gomes da Silva M, Cabeçadas J. Mantle cell lymphoma and chronic lymphocytic leukemia: report of a rare disease association and review of the literature. J Hematop 2010. [DOI: 10.1007/s12308-010-0065-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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69
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Bulian P, Del Poeta G, Gattei V. How would I manage a sample submitted for flow cytometry analysis for suspicious chronic lymphocytic leukaemia. Hematol Oncol 2009; 27:186-9. [DOI: 10.1002/hon.900] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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70
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Mian M, Psenak O, Greil R, Fiegl M, Tzankov A. Diffuse large B-cell lymphoma as a second, clonally unrelated lymphoproliferative disease in a patient with IgM monoclonal gammopathy of undetermined significance (MGUS) and concomitant polycythemia vera rubra. Leuk Lymphoma 2009; 47:940-3. [PMID: 16753887 DOI: 10.1080/10428190500399052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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71
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Hernández JA, Rodríguez AE, González M, Benito R, Fontanillo C, Sandoval V, Romero M, Martín-Núñez G, de Coca AG, Fisac R, Galende J, Recio I, Ortuño F, García JL, de las Rivas J, Gutiérrez NC, San Miguel JF, Hernández JM. A high number of losses in 13q14 chromosome band is associated with a worse outcome and biological differences in patients with B-cell chronic lymphoid leukemia. Haematologica 2009; 94:364-71. [PMID: 19252174 DOI: 10.3324/haematol.13862] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Among patients with B-cell chronic lymphoid leukemia, those with 13q14 deletion have a favorable outcome. However, whether the percentage of cells with 13q- influences the prognosis or the biological characteristics of this disease is unknown. We analyzed the clinico-biological characteristics and outcome of patients with B-cell chronic lymphoid leukemia with loss of 13q as the sole cytogenetic aberration. DESIGN AND METHODS Three hundred and fifty patients with B-cell chronic lymphoid leukemia were studied. Clinical data were collected and fluorescence in situ hybridization and molecular studies were carried out. In addition, a gene expression profile was obtained by microarray-based analysis. RESULTS In 109 out of the 350 cases (31.1%) loss of 13q was the sole cytogenetic aberration at diagnosis. In the subgroup of patients with 80% or more of cells with loss of 13q (18 cases), the overall survival was 56 months compared with not reached in the 91 cases in whom less than 80% of cells had loss of 13q (p< 0.0001). The variables included in the multivariate analysis for overall survival were the percentage of losses of 13q14 (p=0.001) and B symptoms (p=0.007). The time to first therapy in the group with 80% or more vs. less than 80% of losses was 38 months vs. 87 months, respectively (p=0.05). In the multivariate analysis the variables selected were unmutated status of IgV(H) (p=0.001) and a high level of beta(2)microglobulin (p=0.003). Interestingly, these differences regarding overall survival and time to first therapy were also present when other cut-offs were considered. The gene expression profile of patients with a high number of losses in 13q14 showed a high proliferation rate, downregulation of apoptosis-related genes, and dysregulation of genes related to mitochondrial functions. CONCLUSIONS Patients with B-cell chronic lymphoid leukemia with a high number of losses in 13q14 as the sole cytogenetic aberration at diagnosis display different clinical and biological features: short overall survival and time to first therapy as well as more proliferation and less apoptosis. A quantification of the number of cells showing a genetic abnormality should, therefore, be included in the study of the prognostic factors of B-cell chronic lymphoid leukemia.
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72
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Pedreira CE, Costa ES, Barrena S, Lecrevisse Q, Almeida J, van Dongen JJM, Orfao A. Generation of flow cytometry data files with a potentially infinite number of dimensions. Cytometry A 2008; 73:834-46. [PMID: 18629843 DOI: 10.1002/cyto.a.20608] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Immunophenotypic characterization of B-cell chronic lymphoproliferative disorders (B-CLPD) is associated with the use of increasingly larger panels of multiple combinations of 3 to > or =6 monoclonal antibodies (Mab), data analysis being separately performed for each of the different stained sample aliquots. Here, we describe and validate an automated method for calculation of flow cytometric data from several multicolor stainings of the same cell sample--i.e., the merging of data from different aliquots stained with partially overlapping combinations of Mab reagents (focusing on > or =1 cell populations)--into one data file as if it concerned a single "super" multicolor staining. Evaluation of the performance of the method described was done in a group of 60 B-CLPD studied at diagnosis with 18 different reagents in a panel containing six different 3- and 4-color stainings, which systematically contained CD19 for the identification of B-cells. Our results show a high degree of correlation and agreement between originally measured and calculated data about cell surface stainings, providing a basis for the use of this approach for the generation of flow cytometric data files containing information about a virtually infinite number of stainings for each individual cellular event measured in a sample, using a limited number of fluorochrome stainings.
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Affiliation(s)
- Carlos E Pedreira
- Faculty of Medicine and COPPE, Engineering Graduate Program, UFRJ/Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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73
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Fuller SJ, Papaemmanuil E, McKinnon L, Webb E, Sellick GS, Dao-Ung LP, Skarratt KK, Crowther D, Houlston RS, Wiley JS. Analysis of a large multi-generational family provides insight into the genetics of chronic lymphocytic leukemia. Br J Haematol 2008; 142:238-45. [PMID: 18503587 DOI: 10.1111/j.1365-2141.2008.07188.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We report the genetic analysis of a large multi-generational family composed of 144 individuals in which 11 members have been diagnosed with chronic lymphocytic leukaemia (CLL). The observation of a significant over-representation of monoclonal B-cell lymphocytosis (MBL) in unaffected family members strongly supports MBL being a surrogate marker of carrier status. A genome-wide linkage scan of the family using high-density 10K single nucleotide polymorphisms provided no significant evidence for a single gene model of disease susceptibility, inviting speculation that susceptibility to CLL has a more complex basis. The absence of a correlation in IGHV usage between affected family members does however argue strongly against exposure to a single super-antigen in disease development.
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Affiliation(s)
- Stephen J Fuller
- Department of Medicine, The University of Sydney, Nepean Hospital, Penrith, New South Wales, Australia.
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74
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Feldmann G, Nattermann J, Gerhardt T, Nähle CP, Spengler U, Woitas R. Partial remission of a newly diagnosed diffuse large B-cell Non-Hodgkin's lymphoma in a hemodialysis patient after administration of immuno-chemotherapy with rituximab-CHOP. Int J Lab Hematol 2007; 29:469-73. [PMID: 17988304 DOI: 10.1111/j.1365-2257.2006.00879.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
To date little data exist about treatment of hematologic malignancies in patients with end-stage renal disease (ESRD). While administration of immunochemotherapy comprising the CD20-antibody rituximab is a well-established treatment strategy in patients with normal renal function, little information on safety and efficacy is available in the setting of ESRD. Here we describe for the first time a hemodialysis patient suffering from diffuse large B-cell Non-Hodgkin's lymphoma (DLBCL) who was treated with polychemotherapy (cyclophosphamide, doxorubicin, vincristine and prednisone) in combination with rituximab (R-CHOP). We observed no major adverse events and treatment resulted in a partial remission of the DLBCL. Thus, administration of R-CHOP may be considered as a safe therapeutic option in this setting. Of note, this patient had a previous history of hairy cell leukemia. A review of the literature was performed and the potential etiologic link of these two B-cell malignancies is discussed in the light of available information.
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Affiliation(s)
- G Feldmann
- Department of Internal Medicine 1, Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany.
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75
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Sheikholeslami MR, Ma W, Uyeji J, Tornyos K, Cone L, Mamus S, Albitar M. Bi-clonal disease in patients with chronic lymphocytic leukaemia as detected by analysing IGHV mutation status. Br J Haematol 2007; 139:507-9. [PMID: 17868045 DOI: 10.1111/j.1365-2141.2007.06805.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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76
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Delville JP, Heimann P, El Housni H, Boutriaux M, Jeronnez A, Remmelink M, Lasudry J, Pradier O, Kentos A. Biclonal low grade B-cell lymphoma confirmed by both flow cytometry and karyotypic analysis, in spite of a normal kappa/lambda Ig light chain ratio. Am J Hematol 2007; 82:473-80. [PMID: 17211842 DOI: 10.1002/ajh.20850] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Composite low grade lymphoma with two subpopulations in a same site is uncommon. We herewith report the case of an 80-year-old woman who presented with isolated bilateral dacryoadenomegaly. Pathological examination of an incisional biopsy of her right lacrimal gland was consistent with a marginal zone lymphoma. Flow cytometry immunophenotyping showed two distinct clonal B-cell populations expressing sIg D lambda or sIg M kappa restriction in the lacrimal gland, blood, and bone marrow. Both B-cells populations were sorted from peripheral blood for molecular biology investigations and comparison with molecular data performed on tumor and bone marrow cells. IgH PCR performed on purified blood populations disclosed two monoclonal peaks: 98 bp-sized peak in the sIg M kappa and a 107 bp in the sIg D lambda clones, respectively. The lacrimal gland tumor expressed mainly sIg M kappa population, and showed a major 98 bp-sized peak coexisting with a very minor 107 bp peak. Cytogenetic studies showed a 46, XX,del (7) (q22q32) karyotype. Bone marrow examination at diagnosis revealed the same B-cell clones distribution than the one observed in blood with a dominant sIg D lambda population, a Genescan profile showing a major peak of 107 bp and a minor peak of 98 bp. Chromosomal analysis disclosed a 46,XX,del (10) (?p14) karyotype without detectable 7q deletion. To our knowledge, this observation represents the first reported case of biclonal low grade lymphoma hidden behind a normal classical kappa/lambda Ig light chain ratio in blood, but clearly demonstrated by the combination of three ancillary techniques (flow cytometry both analytical and cell sorting, molecular biology, and cytogenetics) and analysis of different tissues (i.e., in this case, lacrimal gland biopsy, blood, and bone marrow).
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Affiliation(s)
- J P Delville
- Flow Cytometry Unit, Department of Immuno-Hemato-Transfusion, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium.
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77
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Kriangkum J, Taylor BJ, Treon SP, Mant MJ, Reiman T, Belch AR, Pilarski LM. Molecular Characterization of Waldenstrom's Macroglobulinemia Reveals Frequent Occurrence of Two B-Cell Clones Having Distinct IgH VDJ Sequences. Clin Cancer Res 2007; 13:2005-13. [PMID: 17404080 DOI: 10.1158/1078-0432.ccr-06-2788] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Malignant B lineage cells in Waldenstrom's macroglobulinemia (WM) express a unique clonotypic IgM VDJ. The occurrence of biclonal B cells and their clonal relationships were characterized. EXPERIMENTAL DESIGN Bone marrow and blood from 20 WM patients were analyzed for clonotypic VDJ sequences, clonal B-cell frequencies, and the complementary determining region 3 profile. RESULTS Two different clonotypic VDJ sequences were identified in 4 of 20 WM. In two cases, partner clones had different VDJ rearrangements, with one clonotypic signature in bone marrow and a second in blood. For both cases, the bone marrow clone was hypermutated, whereas the blood clone was germ line or minimally mutated. In two other cases, partner clones shared a common VDJ rearrangement but had different patterns of somatic mutations. They lacked intraclonal diversity and were more abundant in bone marrow than in blood. VDJ mutation profiles suggested they arose from a common IgM progenitor. Single-cell analysis in one case indicated the partner clones were reciprocally expressed, following rules of allelic exclusion. CONCLUSIONS The existence of two B-cell clones having distinct VDJ sequences is common in WM, suggesting that frequent transformation events may occur. In two cases, the partner clones had distinct tissue distributions in either blood or bone marrow, were of different immunoglobulin isotypes, and in one case exhibited differential response to therapy. The contributions of each clone are unknown. Their presence suggests that WM may involve a background of molecular and cellular events leading to emergence of one or more malignant clones.
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Affiliation(s)
- Jitra Kriangkum
- Departments of Oncology, Cross Cancer Institute and Medicine, University of Alberta, Edmonton, Canada
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78
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Dennis KL, Wallentine SL, Vanveldhuizen PJ, Persons DL, Mathur SC. Biclonal post-transplant B-cell lymphoma: report of a case with two distinct cell populations, XX,t(14;18) and XY,t(11;14). ACTA ACUST UNITED AC 2007; 173:150-3. [PMID: 17321331 DOI: 10.1016/j.cancergencyto.2006.09.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2006] [Revised: 09/19/2006] [Accepted: 09/27/2006] [Indexed: 10/23/2022]
Abstract
Lymphoproliferative disorders are more likely to occur in transplant patients compared to the general population. Typically in these patients, lymphomas occur within 6-10 months following transplant and are Epstein-Barr virus (EBV) positive. We report a biclonal apparently EBV negative lymphoma occurring in a patient ten years after renal transplant, with karyotypes XX,t(14;18) and XY,t(11;14). Though the biclonal populations also had different sex chromosome compositions, complete evaluation showed that both clones most likely evolved from the patient's native lymphocytes.
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MESH Headings
- Aged
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 14
- Chromosomes, Human, Pair 18
- Chromosomes, Human, X
- Chromosomes, Human, Y
- Clone Cells/metabolism
- Clone Cells/pathology
- Humans
- In Situ Hybridization, Fluorescence
- Karyotyping
- Kidney Transplantation
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/pathology
- Male
- Sex Chromosome Aberrations
- Translocation, Genetic
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Affiliation(s)
- Katie L Dennis
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center/Kansas City VA Medical Center, 4801 Linwood Boulevard, Kansas City, Missouri 64128, USA
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79
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Chang H, Cerny J. Molecular Characterization of Chronic Lymphocytic Leukemia With Two Distinct Cell Populations. Am J Clin Pathol 2006. [DOI: 10.1309/0yyf17gfkfjfnp5g] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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80
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Barrena S, Almeida J, Yunta M, López A, Díaz-Mediavilla J, Orfao A, Lazo PA. Discrimination of biclonal B-cell chronic lymphoproliferative neoplasias by tetraspanin antigen expression. Leukemia 2005; 19:1708-9. [PMID: 15973446 DOI: 10.1038/sj.leu.2403858] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
MESH Headings
- Adult
- Antigens, Neoplasm/biosynthesis
- Antigens, Neoplasm/genetics
- B-Lymphocytes/metabolism
- B-Lymphocytes/pathology
- Clone Cells
- Female
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/complications
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Lymphoproliferative Disorders/complications
- Lymphoproliferative Disorders/diagnosis
- Lymphoproliferative Disorders/genetics
- Membrane Proteins/biosynthesis
- Membrane Proteins/genetics
- Splenic Neoplasms/complications
- Splenic Neoplasms/diagnosis
- Splenic Neoplasms/genetics
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81
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Bueso-Ramos CE, Ferrajoli A, Medeiros LJ, Keating MJ, Estrov Z. Aberrant morphology, proliferation, and apoptosis of B-cell chronic lymphocytic leukemia cells. ACTA ACUST UNITED AC 2005; 9:279-86. [PMID: 15621735 DOI: 10.1080/10245330410001727046] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
B-cell chronic lymphocytic leukemia (CLL) has been traditionally described as a disease characterized by an accumulation of quiescent small lymphocytes with decreased susceptibility to apoptotic cell death. However, small numbers of "atypical" lymphocytes and prolymphocytes (PL) are frequently observed in the bone marrow (BM) of patients with CLL. In this study, we examined BM biopsy and aspirate specimens obtained from seven patients with atypical CLL. Using a double labeling (Ki-67+/CD20+) immunohistochemical method, we found that an appreciable number of the atypical CLL cells expressed the proliferation-associated protein Ki-67. Because CLL is characterized by a slow change in the peripheral blood (PB) lymphocyte count, we reasoned that a subpopulation of CLL cells probably undergoes spontaneous apoptosis. Using Western blot analysis, we observed expression of procaspase-9, procaspase-10, and poly(ADP-ribose) polymerase by the neoplastic cells in all seven cases of CLL, and procaspase-3 and procaspase-8 expression in six neoplasms. We also detected cleaved caspase-3 and cleaved poly(ADP-ribose) polymerase in four and five CLL cases, respectively. To determine whether CLL cells undergo spontaneous apoptosis, we performed the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay using BM biopsy specimens. We found TUNEL-positive lymphocytes in areas infiltrated by CLL. In summary, our data show that subpopulations of B-lymphocytes are proliferating or undergoing spontaneous apoptotic cell death in patients with atypical CLL.
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Affiliation(s)
- Carlos E Bueso-Ramos
- Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA
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