Аннотация
Background The distinction between Burkitt's lymphoma and diffuse
large-B-cell lymphoma is unclear. We used transcriptional and genomic
profiling to define Burkitt's lymphoma more precisely and to distinguish
subgroups in other types of mature aggressive B-cell lymphomas.
Methods We performed gene-expression profiling using Affymetrix U133A
GeneChips with RNA from 220 mature aggressive B-cell lymphomas, including
a core group of 8 Burkitt's lymphomas that met all World Health Organization
(WHO) criteria. A molecular signature for Burkitt's lymphoma was
generated, and chromosomal abnormalities were detected with interphase
fluorescence in situ hybridization and array-based comparative genomic
hybridization.
Results We used the molecular signature for Burkitt's lymphoma to
identify 44 cases: 11 had the morphologic features of diffuse large-B-cell
lymphomas, 4 were unclassifiable mature aggressive B-cell lymphomas,
and 29 had a classic or atypical Burkitt's morphologic appearance.
Also, five did not have a detectable IG-myc Burkitt's translocation,
whereas the others contained an IG-myc fusion, mostly in simple karyotypes.
Of the 176 lymphomas without the molecular signature for Burkitt's
lymphoma, 155 were diffuse large-B-cell lymphomas. Of these 155 cases,
21 percent had a chromosomal breakpoint at the myc locus associated
with complex chromosomal changes and an unfavorable clinical course.
Conclusions Our molecular definition of Burkitt's lymphoma clarifies
and extends the spectrum of the WHO criteria for Burkitt's lymphoma.
In mature aggressive B-cell lymphomas without a gene signature for
Burkitt's lymphoma, chromosomal breakpoints at the myc locus were
associated with an adverse clinical outcome.
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