Frequent p53 gene involvement in splenic B-cell leukemia/lymphomas of possible marginal zone origin.

A phenotypic and molecular evaluation was made of 15 patients with mature B-cell leukemia/lymphoma showing exclusive spleen and bone marrow involvement. According to French-American-British criteria, these cases could not be classified as classical B-cell chronic lymphocytic leukemia, hairy cell leukemia and its variant forms, splenic lymphoma with villous lymphocytes, or leukemic phase non-Hodgkin's lymphoma (NHL; follicular or intermediate type). The immunophenotype pattern (high surface Ig and CD25 expression, and little or no reactivity with CD5, CD23, and CD11c) and cytomorphologic features of these neoplasms suggested an origin in the marginal zone of the spleen. Molecular analysis did not show any involvement of the dominantly acting oncogenes generally associated with lymphoid malignancies (c-myc, bcl-2, bcl-1, Ras), but mutations of the p53 tumor suppressor gene involving exons 5, 6, and 8 were found in 6 cases (6 of 15, 40%). In 4 cases, the p53 alterations consisted of a point mutation leading to amino acid substitution. In the remaining 2 cases, an insertion or deletion resulting in a frame-shift of the protein was observed. In all but 1 of the cases, the wild-type sequence at the mutation site was barely visible, implying the loss of the normal p53 allele in leukemic cells. All of the cases showed a clinical course compatible with that of low-grade NHL, regardless of the p53 loss/mutation. Overall, our data suggest the existence of a form of splenic B-cell leukemia/lymphoma of possible marginal zone origin in which p53 inactivation may play an important pathogenetic role.

Structure and function of VLA integrins: differential expression in B-cell leukemia/lymphoma.

The integrin family of adhesion receptors includes at least 11 different alpha subunits and 6 different beta subunits which are associated to form 14 different alpha beta heterodimers, divided into three subfamilies. In particular, beta 1 subfamily integrins (VLA 1-6 proteins) have been found to mediate cell adhesion to extracellular matrix (ECM) component such as fibronectin, collagen, laminin; however, VLA-4 has been found to exhibit both cell-cell and cell-matrix adhesion functions. The reactivity of VLAs is virtually ubiquitous and independent of line or tissue specificity. However, the expression of individual VLAs within single tissues can be modulated according to the type or functional status of the cell. One of the main reasons for interest in these molecules is that they may play a determining role in neoplastic transformation and diffusion; in particular, in lymphoproliferative syndromes, a lack of cell adhesiveness or an abnormal adhesion pattern in neoplastic lymphocytes may free these cells from regulation, thus contributing towards the development of leukemia and/or lymphoma. Studies of VLA expression in B-cell leukemia/lymphomas show a modulation of VLA3 and VLA4 reactivity. The most interesting element is the identification of a VLA3/VLA4 pattern associated with B-cell chronic lymphocytic leukemia (B-CLL) characterised by a reduced expression of VLA4 and the constant expression of VLA3. Although the value of VLA3 as an additional marker for the diagnosis of classical B-CLL is indisputable, the biological/functional significance of this reactivity remains to be confirmed.