Reverse transcription-PCR for t(11;18)(q21;q21) staging and monitoring in mucosa-associated lymphoid tissue lymphoma.

Abstract

PURPOSE:

Subclinical dissemination as well as persistence after therapy may be difficult to assess on clinical and histologic examinations in patients with mucosa-associated lymphoid tissue (MALT) lymphoma. We have analyzed the use of reverse transcription-PCR (RT-PCR) for the detection of t(11;18)(q21;q21) in histologically infiltrated and normal biopsies at diagnosis and during follow-up to determine its clinical and prognostic effect.

EXPERIMENTAL DESIGN:

Twenty-one patients with t(11;18)(q21;q21)+ MALT lymphoma were included in this retrospective study. Presence of t(11;18)(q21;q21) was determined by RT-PCR done on 316 biopsies of various tissues obtained during staging and follow-up.

RESULTS:

Infiltration with lymphoma was histologically detected in 67 of 316 biopsies, whereas molecular infiltration was established in 104 of 316 biopsies. All histologically positive specimens were also positive in RT-PCR. There was a good concordance (P = 0.0001) between histology and RT-PCR at the time of disease presentation with only one further infiltration site identified by RT-PCR. In 8 of 12 patients with persistent lymphoma, RT-PCR revealed tumor infiltration in histologically unsuspected sites. Eight of nine treated patients with histologic and clinical complete remission (CR) remained RT-PCR positive. CR on RT-PCR was achieved later than histologic CR (between 13-59 months) without any further therapy in five of these eight patients; only one patient with persistent t(11;18)(q21;q21) relapsed histologically.

CONCLUSIONS:

This study shows the potential of RT-PCR for t(11;18)(q21;q21) done on routine paraffin-embedded specimens to identify disseminated disease in tissues otherwise not diagnostic of MALT lymphoma involvement. T(11;18)(q21;q21) persistence in patients with clinical and histologic CR does not necessarily require therapeutic intervention.

• Authors: Berthold Streubel, Daniela Huber, Stefan Wöhrer, Andreas Chott, Markus Raderer
• Journal: Clinical cancer research : an official journal of the American Association for Cancer Research (Clin Cancer Res) Vol. 12 Issue 20 Pt 1 Pg. 6023-8 (Oct 15 2006) ISSN: 1078-0432 [Print] United States
• PMID: 17062676 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Aged, 80 and over
• Biopsy
• Chromosomes, Human, Pair 11
• Chromosomes, Human, Pair 21
• Female
• Humans
• Lymphoma, B-Cell, Marginal Zone (genetics, pathology)
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Neoplasm Staging
• Reverse Transcriptase Polymerase Chain Reaction
• Translocation, Genetic