Analysis of Ig Gene in Indolent Malignant Lymphoma and its Application to the Therapy

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Malignant lymphoma cells which derived from the same clonal cell have the same region on the Ig gene, even if the histologic features are changed. For example, follicular lymphoma progressed to the more aggressive lymphoma, same region on the Ia gene can be detected in the both malignant cells, This study was performed to determine the relationship between resistance to therapies and the arrangement of bases of DNA.Furthermore, we intended to improve the treatment outcome applying the results of this study. At the first step, the clinical results (by BACOD-E therapy) were analyzed to detect the cases those were resistant to the therapy. The International Prognosis Index (IPI) and values of LDH were not predictors of the prognosis in this study. One case who developed myelodysplasia syndrome followed by acute myelogenous leukemia, showed chromosome translocation, t(11 ; 19)(q23 ; p13). We further analyzed the other patients including the previous ones. Two hundreds forty four patients were reanalyzed according to Revised European and American Classification for Lymphoid Neoplasms (REAL classification). The incidence of follicle center lymphoma (FCL) was 4.4%, and the most common disease was diffuse large B-cell lymphoma (37%). In this study, IPI was the useful prognostic factor. As the experimental study, lymphoma cells were extracted from the Paraffin-fixed specimen under the microscope. DNA was extracted from these cells and proliferated with PCR.The Ig genes were analyzed for each DNA samples to correlate the histological features. However, until now, there were not any positive relationship between Ig gene analyses and histology or resistance to the therapies.