Role of the molecular staging and response in the management of follicular lymphoma patients
Autor: | Sara Burcheri, Elisa Rumi, Mario Lazzarino, Alessandra Algarotti, Ester Orlandi, Paolo Bernasconi, Francesca Montanari, Luca Arcaini, Maurizio Bonfichi, Nora Colombo, Cristiana Pascutto, Matteo G. Della Porta, Francesco Passamonti, Silvia Calatroni |
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Rok vydání: | 2006 |
Předmět: |
Male
Cancer Research Pathology medicine.medical_specialty bcl-2 Follicular lymphoma Bone Marrow Cells Biology Disease-Free Survival Germline medicine Humans Lymphoma Follicular Aged Neoplasm Staging Gene Rearrangement Incidence (epidemiology) Remission Induction Breakpoint molecular response Hematology Middle Aged medicine.disease Peripheral blood Treatment Outcome medicine.anatomical_structure Proto-Oncogene Proteins c-bcl-2 prognosis Oncology Molecular Response Female Bone marrow After treatment |
Zdroj: | Leukemia & Lymphoma. 47:1018-1022 |
ISSN: | 1029-2403 1042-8194 |
Popis: | Bcl-2/IgH rearrangement is the molecular hallmark of follicular lymphoma which is present in 70 - 90% of cases at diagnosis. The significance of the bcl-2 rearrangement at onset of disease and of its clearing after treatment (molecular response) is still controversial. The aims of the present analysis are: to evaluate the incidence of bcl-2 rearrangement in blood and marrow in a cohort of patients systematically investigated at diagnosis, to describe the correlation between bcl-2 and presenting features, to clarify the correlation of molecular response with outcome. Of 98 patients studied at initial staging for the presence of bcl-2 rearrangement, 64 (65%) showed bcl-2/IgH rearrangement in peripheral blood (PB) and/or bone marrow (BM) (58 at Major Breakpoint Region, MBR, and 6 at minor cluster region, mcr) while no bcl-2/IgH rearrangement was detected in the remaining 34 (35%) (germline status). No statistically significant differences were found between bcl-2 positive and bcl-2 negative cases as concerns presenting clinical features and response to first-line therapy. The median event-free survival, EFS, was not reached for the bcl-2 negative patients in PB and was 11 months for bcl-2 positive patients (statistically significant, P = 0.01) and, similarly, the median EFS was not reached for the bcl-2 negative patients in BM and was 11 months for bcl-2 positive patients (statistically significant, P = 0.04). Of the 64 bcl-2 positive cases, patients were analysed for molecular response (48 in BM and 40 in PB): 16 were molecular responders in BM and 20 were molecular responders in PB. The median EFS was 19 months for molecular responders in PB and 9 months for non-responders; 1-year-EFS was 68% (95% CI; 49 - 88), for responders in PB and 42% (95% CI; 22 - 61) for non-responders (P = 0.05). The median EFS was 11 months both for molecular responders and non-responders in BM; 1-year-EFS was 52% for responders in BM (CI; 30 - 73), and 43% (CI 33 - 71) for non-responders (P = 0.7). No clinical feature showed significant correlation with PB and BM molecular responses. This analysis shows that bcl-2 rearrangement in blood and bone marrow is frequently detected at staging, even in stage I disease. Absence of the bcl-2 rearrangement is related to a better EFS and the achievement of a molecular response in peripheral blood after therapy is associated with a better EFS. |
Databáze: | OpenAIRE |
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