RESUMO
In B-cell non-Hodgkin's lymphomas (NHL), clonal rearrangement of the immunoglobulin heavy chain (IgH) gene provides a useful marker for the detection of minimal residual disease (MRD) after treatment. To explore clinical usefulness of polymerase chain reaction (PCR) analysis of clonal IgH gene rearrangement in the detection of MRD a follow up study of 10 patients with B-cell NHL have been performed. At the time of diagnosis, tumor DNAs were PCR-amplified using sense primer specific for the heavy chain variable region (VH) and antisense primer specific for the heavy chain joining region (JH) of the IgH gene. The clonal rearrangement of IgH gene detected by PCR was used as clonal marker to determine MRD after treatment. In three cases, where clinical remission was not achieved, clonal IgH gene rearrangement was detected after the treatment. In seven cases, clinical remission was achieved after induction therapy but the PCR analysis revealed clonal IgH gene rearrangement in three of the cases. In all of the three cases, where MRD was detected by PCR, clinical relapse developed after 7-28 months of the therapy. In all cases that have relapsed, the IgH gene rearrangement was identical at the time of initial diagnosis and at the relapse. This study demonstrates that PCR analysis of clonal IgH gene rearrangement is a useful method to monitor and detect MRD before clinical relapse.
Assuntos
Biomarcadores Tumorais/genética , Rearranjo Gênico do Linfócito B , Genes de Imunoglobulinas/genética , Cadeias Pesadas de Imunoglobulinas/genética , Linfoma de Células B/diagnóstico , Linfoma de Células B/genética , Reação em Cadeia da Polimerase/métodos , DNA de Neoplasias/genética , Humanos , Neoplasia Residual/diagnósticoRESUMO
50 year old patient with advanced stage Sézary syndrome was treated with extracorporeal photochemotherapy. During extracorporeal photochemotherapy the photoactivable agent 8-methoxypsoralen was administered orally. After 2 h a leucocyte enriched blood fraction was irradiated with UVA extracorporeally and reinfused to the patient. Besides the extracorporeal photochemotherapy Prednisolone and Leukeran were administered. Slow but permanent improvement was observed, the erythroderma, pruritus disappeared, lymph nodes, liver, spleen enlargement reduced, the number of CD4 positive lymphocytes decreased, that of CD8 positive lymphocytes increased.
Assuntos
Transfusão de Componentes Sanguíneos , Fotoquimioterapia , Síndrome de Sézary/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Administração Oral , Clorambucila/uso terapêutico , Terapia Combinada , Humanos , Contagem de Leucócitos/efeitos dos fármacos , Linfócitos/efeitos dos fármacos , Masculino , Metoxaleno/administração & dosagem , Pessoa de Meia-Idade , Prednisolona/uso terapêuticoRESUMO
Plasma samples of patients with angioimmunoblastic lymphadenopathy (AIBL) were tested for anti-HTLV antibodies and for interferon content. Out of 12 patients 4 had antibodies to HTL-III. Two of these plasma samples contained antibodies reacting with HTLV-I and HTLV-II, too. Activated interferon (IFN) system was found in patients with clinical remission of AIBL, as it was detected by IFN titration in their plasma samples. Data suggest the etiological role in AIBL of virus(es) related to the HTLV family.
