Translocation of t(14;18) and its importance in
follow up of minimal residual disease in follicular lymphoma
Obořilová A.1, Dvořáková D.2, Mayer J.1
1Interní hematoonkologická klinika, FN, Brno Bohunice 2Centrum molekulární biologie a genové terapie při Interní hematoonkologické klinice FN, Brno Bohunice |
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Summary:
The importance of t(14;18) reconstruction and better bcl-2/IgH reconstruction in the follow up of
minimal residual disease (MRD) in follicular lymphoma (FL) is not clear up to now. Plenty of reasons
are responsible for that. Low detection of t(14;18) by primer-specific PCR enables follow up of approximately
60% of patients with FL. Some studies doubt correlation between molecular markers and
clinical response. Reconstruction was found in a few other lymphoma types, including non-malignant
lymphadenopaties and even in “healthy” individuals with varying detection between 15-50%. There is
a question if bcl-2/IgH can be a suitable molecular marker for FL at all. Actually, according to detailed
cytogenetic studies, there is an evidence that t(14;18) is sufficiently specific for follicular lymphomas.
But original idea of the only two breakpoint regions does not corresponds to reality. While breakpoint
on the 14th chromosome is relatively constant, more than one third of breakpoints on 18th chromosome
was identified in the region between MBR and MCR. Logically, primer-specific nested PCR for MBR
and MCR can not be effective for bcl-2/IgH determination. Some new and more difficult modifications
of PCR, as multiplexPCRand long-distance PCR, enable the detection of this reconstruction in 80-100 %.
In addition to technical aspects, analysed compartment of residual disease has to be taken into
consideration. The most measured compartment is peripheral blood because of it is easy available.
There are few data definitely confirming that peripheral blood or bone marrow can reliably reflect
disease which originally arise in lymph nodes. Purpose of t(14;18) follow up in MRD in follicular
lymphoma is to choose appropriate technology for its detection and then to test optimal compartment
for molecular determination.
Key words:
follicular lymphoma, minimal residual disease (MRD), t(14;18), bcl-2/IgH
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