The persistence of t(14;18)-bearing cells in lymph nodes of patients with follicular lymphoma in complete remission: the evidence for 'a lymphoma stem cell'

Leuk Lymphoma. 2009 Jul;50(7):1102-9. doi: 10.1080/10428190902927005.

Abstract

Monitoring of t(14;18) in blood or bone marrow in follicular lymphoma (FL) remains controversial. We attempted to monitor t(14;18) in lymph nodes by ultrasound-guided fine needle aspirations (UG-FNA). First, we confirmed t(14;18) in 27/31 UG-FNAs of lymph nodes with fluorescent in situ hybridisation (FISH) and/or polymerase chain reaction (PCR) in patients with advanced disease. In complete (CR) and molecular remission, there were repeated 18 UG-FNAs in 17 patients. Five of 18 UG-FNA were technically unsuccessful and 6/18 samples contained fibrosis. Despite that, these patients had a better prognosis. In 7/7 aspirations in six patients, t(14;18) was detected. Three patients are still in CR, even one of them remains in long lasting remission despite two consecutive evidences of t(14;18) in UG-FNA. Another three of these patients relapsed a few months after UG-FNA. This study is proof of the principle of the detection of residual t(14;18) bearing cells in previously involved lymph nodes despite patients being in remission.

MeSH terms

  • Adult
  • Aged
  • Chromosomes, Human, Pair 14*
  • Chromosomes, Human, Pair 18*
  • Female
  • Humans
  • In Situ Hybridization, Fluorescence
  • Lymph Nodes / pathology
  • Lymphoma, Follicular / genetics*
  • Lymphoma, Follicular / therapy*
  • Male
  • Middle Aged
  • Neoplastic Stem Cells / cytology*
  • Prognosis
  • Proto-Oncogene Proteins c-bcl-2 / metabolism
  • Remission Induction
  • Treatment Outcome

Substances

  • Proto-Oncogene Proteins c-bcl-2