BCL-2/IgH and IgH gene rearrangements in bone marrow mononuclear cells of patients with non-Hodgkin's lymphoma / 中国实验血液学杂志

ABSTRACT

This study was purposed to investigate the BCL-2/IgH gene rearrangement in major break point region (MBR) and IgH gene rearrangements of patients with non-Hodgkin's lymphoma (NHL), and explore their significance for improving early diagnosis and accurately evaluating chemotherapy effect. DNA for BCL-2/IgH and IgH gene assays was extracted from bone marrow mononuclear cells in 70 cases of lymphoma (60 cases of B-NHL and 10 cases of T-NHL), 7 cases of lymph node inflammatory and 20 healthy controls. The BCL-2/IgH, IgH gene rearrangements were assayed by polymerase chain reaction (PCR), the assayed results were compared with results of pathological biopsy; the factors related with occurrence of these 2 kinds of gene rearrangement were analyzed and the dynamic changes of BCL-2/IgH and IgH gene rearrangements after chemotherapy were compared, the chemotherapy effect was evaluated. The results indicated that (1) BCL-2/IgH gene rearrangement in bone marrow mononuclear cells was observed in 10 cases out of 30 DLBCL cases (33.3%), and was more frequent than that in 30 other B-NHL cases (6.7%), 10 T-NHL cases (0%), 7 lymph nodes inflammatory cases (0%) and 20 healthy controls (5%) (p < 0.05). (2) the quantity of rearranged BCL-2/IgH gene of 8 DLBCL cases reduced from 0.59 to 0.16 (p < 0.05) after 2 courses of R-CHOP chemotherapy and completely disappeared after 6 courses of R-CHOP chemotherapy. (3) 81.8% patients with BCL-2/IgH gene rearrangement showed high serum LDH level, while it was observed in 28.6% patients without this gene rearrangement (p < 0.05). Lymphoma staging, systemic symptoms, β(2)-MG level, bone marrow involvement, infiltration of liver and spleen were not significantly correlated with BCL-2/IgH gene rearrangement. (4) IgH gene rearrangement was found in 9 cases out of 20 DLBCL patients (all newly diagnosed patients) (45%), IgH rearrangement was observed in 14 cases out of 30 other B-NHL (all newly diagnosed or relapsed patients, except patients with DLBCL) (46.7%) and there was no statistical difference between these 2 groups, however IgH rearrangement all were not observed in 20 healthy persons, 10 T-NHL cases and 7 lymph nodes inflammatory cases. (5) the quantity of rearranged IgH gene in 7 DLBCL cases was reduced from 0.42 to 0.13 after one course of R-CHOP chemotherapy (p < 0.05) and completely disappeared after 2 courses of R-CHOP chemotherapy. (6) 90% patients with IgH gene rearrangement had high serum LDH level, while it was found in 30% patients without this gene rearrangement (p < 0.05). Lymphoma staging, systemic symptoms, β(2)-MG levels, bone marrow involvement, infiltrations liver and spleen all were not significantly correlated with IgH gene rearrangement. It is concluded that the BCL-2/IgH and IgH gene rearrangements may be used as specific indicators in early diagnosis and accurate evaluation of therapy efficacy in B-NHL, these 2 kind of rearrangement correlate with LDH level. The BCL-2/IgH gene rearrangement is more specific for in DLBCL.