Primary central nervous system lymphoma: tumor-related clones exist in the blood and bone marrow with evidence for separate development
Primary central nervous system lymphoma: tumor-related clones exist in the blood and bone marrow with evidence for separate development
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DOI：
10.1182/blood-2008-09-179366
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发表时间：
2009-05-07
期刊：
影响因子：
20.3
通讯作者：
Ottensmeier, Christian H.
中科院分区：
文献类型：
--
作者：
McCann, Katy J.;Ashton-Key, Margaret;Ottensmeier, Christian H.
原发性中枢神经系统（CNS）淋巴瘤是一种侵袭性B细胞肿瘤，临床上定义为无全身性疾病。我们已经使用免疫球蛋白可变（V）基因分析，以确定肿瘤细胞在中枢神经系统网站在12例，并探讨在3例患者的外周组织的参与。克隆追踪显示，3例中的3例在骨髓和/或血液中有肿瘤细胞，有证据表明外周部位的V基因突变活性增加。在3例中的2例中，克隆内变异分析显示与脑活检相同，但检测到脑外部位特有的其他变异。这些发现表明，外周肿瘤细胞可以在局部进行单独的发育，而不会再进入大脑。原发性中枢神经系统淋巴瘤似乎同时具有中枢神经系统特异性成分和全身性成分，但交换有限。中枢神经系统中肿瘤细胞的恶性程度越高，提示局部环境的影响或外周克隆的恶性程度越低。（血。2009;113：4677-4680）
Primary central nervous system (CNS) lymphoma is an aggressive B-cell tumor that is defined clinically by the absence of systemic disease. We have used immunoglobulin variable (V)-gene analysis to identify tumor cells at the CNS site in 12 cases and to probe the involvement of peripheral tissues in 3 patients. Clonal tracking revealed tumor cells in the bone marrow and/or blood for 3 of 3 cases, with evidence for increased V-gene mutational activity at peripheral sites. In 2 of 3 cases, intraclonal variant analysis revealed identity with the brain biopsy but detected additional variants unique to extracerebral sites. These findings suggest that peripheral tumor cells can undergo separate development locally with no reentry into the brain. Primary CNS lymphoma appears to have both CNS-specific and systemic components with limited interchange. The more malignant behavior of tumor cells in the CNS suggests either a local environmental influence or a less malignant phenotype of the peripheral clone. (Blood. 2009;113:4677-4680)