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The prognostic significance of monoclonal immunoglobulin gene rearrangement in conjunction with histologic B-cell aggregates in the bone marrow of patients with diffuse large B-cell lymphoma.

Authors
 Yoon Ah Cho  ;  Woo Ick Yang  ;  Jae-Woo Song  ;  Yoo Hong Min  ;  Sun Och Yoon 
Citation
 CANCER MEDICINE, Vol.5(6) : 1066-1073, 2016 
Journal Title
 CANCER MEDICINE 
Issue Date
2016
MeSH
Adult ; Aged ; B-Lymphocytes/metabolism* ; B-Lymphocytes/pathology* ; Biomarkers ; Bone Marrow/pathology* ; Cell Aggregation ; Female ; Gene Rearrangement, B-Lymphocyte* ; Genes, Immunoglobulin* ; Humans ; Lymphoma, Large B-Cell, Diffuse/diagnosis* ; Lymphoma, Large B-Cell, Diffuse/genetics* ; Lymphoma, Large B-Cell, Diffuse/mortality ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models
Keywords
Bone marrow ; diffuse large B-cell lymphoma ; immunoglobulin genes ; lymphoid aggregates ; prognosis
Abstract
Bone marrow involvement (BMI) is a well-known poor prognostic factor in patients with diffuse large B-cell lymphoma (DLBCL). This study robustly investigated the significance of monoclonal immunoglobulin gene rearrangement combined with histologic B-cell aggregates in bone marrow (BM) in the detection of a poor prognostic group. Pretreatment BM samples of 394 DLBCL patients were analyzed via the immunoglobulin gene rearrangement study and the microscopic examination. Monoclonal immunoglobulin gene rearrangement was detected in 25.4% of cases. Histologic B-cell aggregates with the features of large B-cell lymphoma aggregates, small cell B-cell lymphoma aggregates, or B-cell aggregates of unknown biological potential were observed in 12% of cases (6.9%, 1.3%, and 3.8%, respectively). Histologic B-cell aggregates were more associated with monoclonality than polyclonality. Cases with both monoclonality and histologic B-cell aggregates demonstrated close association with poor prognostic factors such as a higher International Prognostic Index score and showed an inferior overall survival rate when compared to cases with only monoclonality or only histologic B-cell aggregates. From the findings, a combination of monoclonality and histologic B-cell aggregates within the bone marrow was highly associated with poor prognosis and could be used to determine high-risk DLBLC patients with greater sensitivity and specificity than conventional microscopic examination or immunoglobulin gene rearrangement study alone.
Files in This Item:
T201602020.pdf Download
DOI
10.1002/cam4.679
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Min, Yoo Hong(민유홍) ORCID logo https://orcid.org/0000-0001-8542-9583
Song, Jae Woo(송재우) ORCID logo https://orcid.org/0000-0002-1877-5731
Yang, Woo Ick(양우익) ORCID logo https://orcid.org/0000-0002-6084-5019
Yoon, Sun Och(윤선옥) ORCID logo https://orcid.org/0000-0002-5115-1402
Cho, Yoon Ah(조윤아)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/147046
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