Lymphoid neoplasms associated with concurrent t(14;18) and 8q24/c-MYC translocation generally have a poor prognosis
Lymphoid neoplasms associated with concurrent t(14;18) and 8q24/c-MYC translocation generally have a poor prognosis
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DOI：
10.1038/modpathol.3800500
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发表时间：
2006-01-01
期刊：
影响因子：
7.5
通讯作者：
Lin, P
中科院分区：
文献类型：
--
作者：
Kanungo, A;Medeiros, LJ;Lin, P
我们通过常规细胞遗传学或荧光原位杂交分析发现了14例同时存在t（14; 18）和染色体8 q24或c-MYC易位的B细胞肿瘤。所有病例经常规细胞遗传学检查均为复杂核型。有10名男性和4名女性，中位年龄为55岁（范围，29 - 72岁）。这些患者均无滤泡性淋巴瘤病史。活检标本取自骨髓、淋巴结和淋巴结部位。形态学上，9例肿瘤具有伯基特或非典型伯基特淋巴瘤/白血病的特征，3例为弥漫性大B细胞淋巴瘤，具有高级别细胞学特征。其余2例分别为浆母细胞性骨髓瘤和低度恶性B细胞淋巴瘤。所有病例均表达BCL-2。用Ki-67（MIB 1）评估的增殖指数在低度恶性B细胞淋巴瘤中为5%，在浆细胞性骨髓瘤中为80%，在3例弥漫性大B细胞淋巴瘤中为90 - 95%，在大多数Burkitt和非典型Burkitt肿瘤中为90->99%。低级别B细胞淋巴瘤患者接受利妥昔单抗治疗。所有其他患者均接受强化联合化疗。其中2例患者接受了骨髓移植，1例患者除移植外还接受了放射治疗。中位随访期为9个月（范围，3 - 81）。总共有10名患者死亡，中位生存期为9个月（范围，3 - 81）。我们的结论是，大多数B细胞淋巴瘤并发t（14; 18）和8 q24/c-MYC易位属于弥漫性大B细胞淋巴瘤和伯基特淋巴瘤的形态学谱。这些肿瘤是高级别的，并且与不良预后相关。然而，这种分子异常的组合也很少发生在其他肿瘤中，例如本研究中的低级别B细胞淋巴瘤和浆细胞性骨髓瘤病例。
We identified 14 B-cell neoplasms with concurrent t(14; 18) and chromosome 8q24 or c-MYC translocations shown by conventional cytogenetics or fluorescence in situ hybridization analysis. All cases assessed by conventional cytogenetics had a complex karyotype. There were 10 men and four women, with a median age of 55 years ( range, 29 - 72). None of these patients had a history of follicular lymphoma. The biopsy specimens were obtained from bone marrow, lymph node, and extranodal sites. Morphologically, nine neoplasms had features of Burkitt or atypical Burkitt lymphoma/leukemia and three were diffuse large B-cell lymphoma with high-grade cytologic features. The remaining two cases were plasmablastic myeloma and low-grade B-cell lymphoma, respectively. All cases expressed BCL-2. The proliferation index assessed by using Ki-67 (MIB1) was 5% in the low-grade B-cell lymphoma, 80% in the plasmablastic myeloma, 90 - 95% in three cases of diffuse large B-cell lymphoma, and ranged from 90 to >99% in most Burkitt and atypical Burkitt neoplasms. The patient with low- grade B-cell lymphoma was treated with rituximab. All other patients received intensive combination chemotherapy. Two of these patients underwent bone marrow transplantation, and one patient received radiation therapy in addition to transplantation. The median follow-up period was 9 months ( range, 3 - 81). In all, 10 patients died with a median survival of 9 months ( range, 3 - 81). We conclude that most B-cell lymphomas with concurrent t(14; 18) and 8q24/c-MYC translocations fall within the morphologic spectrum of diffuse large B-cell and Burkitt lymphoma. These neoplasms are high-grade and are associated with a poor prognosis. However, this combination of molecular abnormalities can also rarely occur in other neoplasms, such as the cases of low- grade B-cell lymphoma and plasmablastic myeloma in this study.