Practical Aspects and Clinical Value of t(14;18)
Monitoring in Peripheral Blood of the Follicular Lymphoma Patients
1Janíková–Obořilová A., 1Mayer J., 1Dvořáková D., 1Mejstřík P., 1Navrátil M., 1Vášová I., 2Křen L., 3Matuška M.
1Interní hematoonkologická klinika FN, Brno 2Patologicko–anatomický ústav FN, Brno3Onkologické oddělení FN, Ostrava |
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Summary:
Background. Evaluation of practical value of monitoring t(14;18) in peripheral blood in follicular
lymphoma.
Methods and Results. t(14;18) was tested in 115 follicular lymphoma patients by methods: FISH,
nested and multiplex PCR of blood, bone marrow and lymph node specimens. We tested the patients
with rearrangement MBR quantitatively by real-time PCR. Testing intervals of t(14;18) in peripheral
blood were 1 month during treatment, 2–3 months during the first year after the end of treatment, then
every 4 to 6 months. Patients were clinically examined in the same intervals and regular restaging was
done by CT/PET. Each patient was evaluatee separately. Total detection of t(14;18) was 97 % regardless
tissue and methods of detection, FISH was superior to PCR (95 % vs 72 %). The higher number of copies
were observed in lymph nodes in comparison to bone marrow (p=0,036) and peripheral blood (p=0,016);
46/115 (40 %) patients were positive for MBR, we followed up behaviour of t(14;18) in peripheral blood
in 33 of them in long intervals (>6 months, med. 33 months). Molecular and clinical courses correlated
in 20/33 (61 %) patients, 7/33 (21 %) clinically relapsed in lasting molecular remission. We found very
short interval to clinical relaps in 7 cases of molecular relapses (0–5 months, median 3 months). We
could not define “threshold quantity” of clinically important molecular relaps. Lasting molecular
remission was associated with clinical in about 60 % cases; lasting molecular activity corresponded with
clinical relaps in 86 % patients.
Conclusions. t(14;18) is highly associated with follicular lymphoma. In practice, monitoring of t(14;18)
is feasible only in part of patients. Even if there is some correlation of clinical and molecular course, monitoring of t(14;18) in blood bears only limited prognostic value for the concrete patient. The
treatment of patient can not be accomplished on the basis of these results only.
Key words:
follicullar lymphoma, t(14;18), bcl-2/IgH.
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