Correlation of PCR-detected clonal gene rearrangements with bone marrow morphology in patients with B-lineage lymphomas

被引:51
作者
Coad, JE
Olson, DJ
Christensen, DR
Lander, TA
Chibbar, R
McGlennen, RC
Brunning, RD
机构
[1] UNIV MINNESOTA, SCH MED, DEPT LAB MED & PATHOL, DIV HEMATOPATHOL, MINNEAPOLIS, MN 55455 USA
[2] UNIV MINNESOTA, SCH MED, DEPT LAB MED & PATHOL, DIV MOL DIAGNOST, MINNEAPOLIS, MN 55455 USA
关键词
B-lineage non-Hodgkin's lymphoma; bone marrow morphology; polymerase chain reactions; minimal disease detection;
D O I
10.1097/00000478-199709000-00009
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Bone marrow biopsy is the conventional staging and posttherapy evaluation method for assessing marrow involvement by lymphoma. Polymerase chain reactions (PCR) for antigen receptor rearrangements have the potential to increase the detection of minimal de rees of marrow involvement. The present study is a concurrent morphologic and PCR evaluation of 225 staging or posttherapy marrow biopsies from 127 patients with B-lineage non-Hodgkin's lymphoma. The biopsies were morphologically categorized into four groups: group 1 (positive for lymphoma), 60 biopsies (27%); group 2 (suspicious for lymphoma), 20 biopsies (9%); group 3 (lymphocytic lesions of indeterminate biology), 22 biopsies (10%); and group 4 (negative for lymphoma), 123 biopsies (54%). Molecular studies were performed on concurrently obtained aspirates and used consensus immunoglobulin-heavy-chain (IgH) and IgH/bcl-2 gene PCR primers. A molecular clone was detected in 53 of the 225 aspirates (24%): group 1, 34 aspirates (57%); group 2, five aspirates (25%); group 3, one aspirate (5%): and group 4, 13 aspirates (11%). A PCR-positive aspirate was present in 47% of follicular lymphomas, 58% of diffuse large cell lymphomas, and 72% of the other lymphomas in the group I specimens. Morphology or PCR was positive in 79 of the 225 cases (35%). The molecular detection of clonality in the aspirate DNA from cases with positive morphologic findings was lower than anticipated. The discordance between morphology and PCF, results may be related to sample variation between the trephine biopsy and aspirate, a failure to aspirate sufficient lymphoma cells, or insufficient primer homology for amplification. UNA extracted from trephine sections may provide results more concordant with morphology, because PCR detected a clone in 10 of 11 DNA specimens extracted from trephine biopsies with positive morphologic findings and PCR negative aspirates.
引用
收藏
页码:1047 / 1056
页数:10
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