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Translocation t(14;18)/IGH-BCL2 in gastrointestinal follicular lymphoma
Correlation with clinicopathologic features in 48 patients
Article first published online: 29 DEC 2010
Copyright © 2010 American Cancer Society
Volume 117, Issue 11, pages 2467–2477, 1 June 2011
How to Cite
Yanai, S., Nakamura, S., Takeshita, M., Fujita, K., Hirahashi, M., Kawasaki, K., Kurahara, K., Sakai, Y. and Matsumoto, T. (2011), Translocation t(14;18)/IGH-BCL2 in gastrointestinal follicular lymphoma. Cancer, 117: 2467–2477. doi: 10.1002/cncr.25811
- Issue published online: 19 MAY 2011
- Article first published online: 29 DEC 2010
- Manuscript Accepted: 28 OCT 2010
- Manuscript Revised: 16 OCT 2010
- Manuscript Received: 7 SEP 2010
- follicular lymphoma;
- gastrointestinal lymphoma;
- t(14;18)(q32, q21);
Chromosomal translocation t(14;18)(q32;q21) involving the immunoglobulin heavy chain gene (IGH) and the BCL2 gene (t[14;18][q32;q21]/IGH-BCL2) is present in 60% to 90% of nodal follicular lymphomas. To the authors' knowledge, the prevalence and clinical significance of this translocation have not been examined previously in gastrointestinal follicular lymphomas.
Clinicopathologic and molecular features were investigated in 48 patients who had gastrointestinal follicular lymphoma. The site of involvement was the duodenum in 54% of patients, the jejunum in 52%, the ileum in 52%, the stomach in 29%, and the colorectum in 15%. The presence of the t(14;18)/IGH-BCL2 translocation was detected by interphase fluorescence in situ hybridization.
Treatment modalities included surgical resection (n = 16), rituximab plus chemotherapy (n = 13), rituximab alone (n = 6), antibiotics (n = 5), and watchful waiting (n = 8). Complete remission (CR) of lymphoma was achieved in 31 patients (65%). The overall survival and event-free survival rates after 5 years were 93% and 68%, respectively. The t(14;18)/IGH-BCL2 was detected in 39 patients (81%). The involvement of multiple sites (69% vs 0%), manifestation of the lymphomatous polyposis type (72% vs 22%), and histologic grade 1 or 2 tumors (92% vs 56%) were more frequent in the t(14;18)-positive group than in the negative group. In addition, the CR rate was lower in the t(14;18)-positive group than in the negative group (56% vs 100%; P = .0179), and a trend was observed toward poorer event-free survival in the positive group (P = .089).
The t(14;18)/IGH-BCL2 chromosomal translocation occurred frequently in gastrointestinal follicular lymphomas. The current results indicated that this translocation may be a predictor of an adverse clinical course. Cancer 2011. © 2010 American Cancer Society.