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

来源于同一克隆细胞的恶性淋巴瘤细胞，即使其组织学特征发生改变，其Ig基因上也具有相同的区域。如滤泡性淋巴瘤进展为侵袭性淋巴瘤时，在两种恶性细胞中均可检测到Ia基因上的相同区域，本研究旨在确定治疗耐药与DNA碱基排列的关系。此外，我们打算应用本研究的结果来改善治疗结果。首先对临床结果（采用BACOD-E治疗）进行分析，发现耐药病例。在本研究中，国际预后指数（IPI）和LDH值不是预后的预测因子。1例骨髓发育不良综合征并发急性髓系白血病患者出现染色体易位，t(11; 19)（q23; p13）。我们进一步分析了其他患者，包括之前的患者。根据修订的欧美淋巴肿瘤分类（REAL分类）对224例患者进行重新分析。滤泡中心淋巴瘤（FCL）发生率为4.4%，弥漫性大b细胞淋巴瘤（37%）最为常见。在本研究中，IPI是有用的预后因素。作为实验研究，在显微镜下从石蜡固定标本中提取淋巴瘤细胞。从这些细胞中提取DNA，用PCR扩增。分析每个DNA样本的Ig基因以关联组织学特征。然而，到目前为止，Ig基因分析与组织学或对治疗的耐药性之间没有任何正相关。

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.