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Residual Disease in Non-Hodgkin's Lymphomas

Prognostic significance of molecular staging by PCR-amplification of immunoglobulin gene rearrangements in diffuse large B-cell lymphoma (DLBCL)

Leukemia volume 18, pages 1102–1107 (2004)Cite this article

Abstract

The prognostic value of the detection of peripheral blood (PB) and/or bone marrow (BM) involvement by polymerase chain reaction (PCR) amplification of rearranged immunoglobulin heavy chain (IgH) and immunoglobulin kappa light chain (Igκ) genes was evaluated in 155 patients with diffuse large B-cell lymphomas (DLBCL). Immunoglobulin gene rearrangements (IgR) were detected in 35/155 (23%) patients. The presence of IgR in PB/BM was related to clinical stage (CS I–III vs CS IV; P<0.001), histopathological detection of BM involvement (P<0.001), and the International Prognostic Index (P<0.001). IgR-positive cases had a significantly lower complete remission (CR) rate (18/35, 51%) than IgR-negative patients (85/120, 71%; P=0.042), and a significantly poorer overall survival (OAS) at 5 years (25 vs 66%; P<0.001). There was a significant difference in the estimated OAS at 5 years between patients with negative BM histology and negative PCR results (66%), patients with negative BM histology but positive IgR (37%), and patients with positive BM histology (12%). Our results indicate that molecular methods improve the accuracy of staging in patients with DLBCL and define a group of patients with normal bone marrow histology who have a significantly poorer OAS due to molecular detection of PB/BM involvement.

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Acknowledgements

We are indebted to Susanne Hagmann for expert assistance with data management, and to Monika Heimbach and Helmut Sommer for excellent technical assistance. This study was supported by the FWF Grant P 13984-GEN and the Center of Molecular Medicine of the Austrian Academy of Sciences, and by Grant NB 9964 of the Austrian National Bank.

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Authors and Affiliations

  1. Division of Molecular Diagnostics, Clinical Institute of Medical and Chemical Laboratory Diagnostics, University of Vienna, Medical School, Währinger Gürtel, Vienna, Austria

    G Mitterbauer-Hohendanner, C Mannhalter & K Winkler

  2. Department of Internal Medicine I, Division of Hematology, University of Vienna, Medical School, Währinger Gürtel, Vienna, Austria

    M Mitterbauer, C Skrabs, K Lechner & U Jaeger

  3. Department of Clinical Pathology, University of Vienna, Medical School, Währinger Gürtel, Vienna, Austria

    A Chott & I Simonitsch-Klupp

  4. Department of Medical Computer Sciences, Section of Clinical Biometrics, University of Vienna, Medical School, Währinger Gürtel, Vienna, Austria

    A Gleiß

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  1. G Mitterbauer-Hohendanner
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Correspondence to U Jaeger.

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Mitterbauer-Hohendanner, G., Mannhalter, C., Winkler, K. et al. Prognostic significance of molecular staging by PCR-amplification of immunoglobulin gene rearrangements in diffuse large B-cell lymphoma (DLBCL). Leukemia 18, 1102–1107 (2004). https://doi.org/10.1038/sj.leu.2403376

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