Bcl-2 gene rearrangement in Jordanian follicular and diffuse large B-cell lymphomas

Follicular lymphoma [FL], a common subtype of non-Hodgkin's lymphoma [NHL] in the West, represents a rare subtype in Jordan. Bcl-2 gene rearrangement plays a crucial role in the biology of the vast majority of FL and a substantial number of diffuse large B-cell lymphoma [DLBCL] in the West; but its presence has not been studied in Jordan. Our aims are to document if bcl-2 gene rearrangement exists in Jordanian FL and DLBCL, and if present to determine whether its frequency among these lymphomas is different from the West and therefore may be responsible for some of the epidemiological differences seen between Jordan and the West. The study was conducted in the year 2001 using polymerase chain reaction [PCR], to detect bcl-2 gene rearrangement in paraffin sections in 5 FL and 23 DLBCL cases diagnosed at the Department of Pathology at Jordan University of Science and Technology, Irbid, Jordan. Two sets of primers including the major breakpoint region [MBR] and the minor cluster region [MCR] were used. Amplifiable DNA was extracted from all cases. Bcl-2 gene rearrangement was seen among 4 [80%] of 5 FL cases, and 8 [35%] of 23 DLBCL cases. The majority of the rearrangements involved the MBR; however, one fourth of cases [one of 4 FL; 2 of 8 DLBCL] with bcl-2 rearrangement involved the MCR. Bcl-2 gene rearrangement was seen in the vast majority of Jordanian FL cases and approximately one third of all DLBCL cases. These figures are similar to those reported in the West, and therefore bcl-2 gene rearrangement does not help in explaining the epidemiological differences of NHL between Jordan and the West. The presence of bcl-2 gene rearrangement in DLBCL may define a subset of lymphomas that may be biologically and clinically unique and different from the rest of DLBCL

Non-Hodgkin Lymphoma in Jordan. Types and patterns of 111 cases classified according to the WHO classification of hematological malignancies

Non-Hodgkin lymphoma [NHL] is one of the most frequent malignancies in Jordan. The aims of this study are: 1. To classify NHL cases in Jordan, using the new World Health Organization [WHO] classification system, 2. To identify the most common types of NHL in Jordan, and 3. To compare lymphoma types and patterns in Jordan with those in surrounding countries and the West. We studied all NHL cases, diagnosed during 1996 through to 1999 inclusive, at 2 major medical centers in Jordan, in order to identify their main types and patterns. One hundred and eleven cases of confirmed NHLs were reexamined and immunophenotyped in the year 2000, at the Department of Pathology, Jordan University of Science and Technology, Irbid, Jordan, using an immunohistochemical panel of antibodies, including CD3, CD15, CD20, CD30, CD43, CD45 and CD45RO. Confirmed NHL cases were reclassified according to the recently proposed WHO system of Hematological Malignancies. The median age of NHL cases was 44-years [range 2-85]. The vast majority of cases were of B-cell phenotype; only 14% of the cases were T-cell lymphomas. Most of the cases were of the aggressive intermediate to high-grade large cell type. Diffuse large B-cell lymphoma [DLBCL] comprised 53% of NHLs and 62% of B-cell NHLs. Indolent lymphomas were uncommon, comprising 14% of all NHL cases. Twenty-nine cases were seen among patients less than 20-years. Burkitt lymphoma represented the largest group [55%] of the childhood NHLs followed by diffuse large cell and lymphoblastic types. Indolent lymphomas are rare in Jordan and account for less than 15% of all NHLs. Aggressive lymphomas; on the other h and, account for the majority of NHLs in Jordan. Burkitt lymphoma affected children less than 10-years of age with a median of 4.5-years. These observations indicate that NHLs in Jordan have different type distribution and patterns from those seen in the West

Epstein-barr virus expression in Hodgkin's disease in Jordan

Epstein-Barr virus [EBV] has been associated with many hematopoietic malignancies including Hodgkin's disease [HD]. The association of HD correlates with the histologic subtype, age of presentation and geographic location. Our aims were to find out if EBV is associated with Jordanian HD; and if EBV association exists, to determine its relationship to certain age groups or specific histologic subtypes of HD; and finally to establish whether such association follows patterns seen in developing or developed countries. We have examined 64 cases of HD diagnosed in 2 major medical centers in Jordan for evidence of EBV association. We used immunohistochemistry and in-situ hybridization techniques to detect latent membrane protein [LMP-1] and Epstein-Barr virus encoded RNA [EBER] in the Reed-Sternberg cells. The study was conducted at the Department of Pathology, Jordan University of Science and Technology, Irbid, Jordan in the years 2000 and 2001. Epstein Barr virus was seen in 47% of our cases: 22 [65%] of the 34 mixed cellularity and 8 [29%] of 28 nodular sclerosis HD. None of our 2 lymphocyte predominant HD cases showed evidence of EBV. Epstein-Barr virus was seen in 73% of HD cases in children below 15 years of age as opposed to 34% of the young adult group. Our results confirm the presence of EBV in Jordanian HD in approximately half of the cases, a figure close to those reported in the West. Epstein-Barr virus association with HD in Jordan is seen mostly in the mixed cellularity subtype and childhood HD

Hodgkins' lymphoma in North Jordan. Does it have a different pattern?

To study the pattern of Hodgkin's lymphoma [HL] in North Jordan, identify the epidemiological features of this disease, and to see if these patterns are unique or follow the patterns seen in developed or developing countries. All of the cases of HL diagnosed at the Department of Pathology, Jordan University of Science and Technology, Irbid, Jordan between January 1996 and September 2002 were retrieved and reviewed histologically. Seventy-five confirmed HL cases were classified according to the WHO classification of hematological malignancies. Data on the age and gender of the patients were correlated with those of the histopathologic types of the disease. Patients range in age from 3-72 years with a median of 20 years. The young adult population [15-34 years] was the largest group in this study accounting for 45.9% of all cases followed by the childhood group [0-14 years], which accounted for 25.6% of the cases. The age distribution displayed only one peak between 11 and 20 years. Classic HL accounted for 91% of the cases, half of these cases belong to the mixed cellularity [MC] type and 46% belong to the nodular sclerosis [NS] type. The overall male to female ratio was 1.7:1; but the ratio was the highest [3.75:1] among children, and reversed among patients with NS type in the young adult group [0.78:1]. The MC and NS types of HL accounted for the vast majority of HL in North Jordan. Similar to other developing countries the MC type of HL was the most common type followed by the NS type. The age distribution displayed a unimodal pattern with a peak between 11 and 20 years of age, which is a decade earlier than the first peak seen in the West. This pattern is also different from developing countries, where HL peaks in children less than 10 years of age. Hodgkin's lymphoma in Jordan appears to have an intermediate pattern between developing countries and the West

role of young population structure in determining age distribution of breast cancer in Jordan

Previous reports noted a high proportion of young Jordanian breast cancer [BC] patients. This study was performed to find whether this is reproducible and to examine the role, if any, of a young population structure in causing this. We hypothesized that the age distribution [AD] of BC in Jordan is independent from the population structure. By finding that the AD of BC in a model population, where the population structure of Jordan is similar to the USA, was significantly different [P = 0.01] from the observed AD in Jordan, we rejected this hypothesis. We conclude that a young population structure, as well as a low incidence in older patients, are the main reasone behind a high proportion of young patients with BC in Jordan. This may also be valid in other countries having an early onset/low incidence rate of BC