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Malignant Lymphomas |
1 Depts. of Pathology, University of Barcelona, Barcelona, Spain
2 Institute of Pathology, University of Würzburg, Würzburg, Germany
3 Metabolism Branch
4 Biometric Research Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
5 Dept. of Pathology, University Medical Center Groningen, Groningen, The Netherlands
6 Dept. of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
7 Hematology, Hospital Clínic, University of Barcelona, Barcelona, Spain
8 British Columbia Cancer Agency, Vancouver, B.C., Canada
9 Norwegian Radium Hospital, Norway Hospital Clinic, Oslo, Norway
10 Dept. of Pathology, University of Arizona, Tucson, AZ, USA
11 Dept. of Pathology, Oregon Health and Sciences University, Portland, OR, USA
12 Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
13 Institute of Clinical Pathology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
Correspondence: Andreas Rosenwald, Institute of Pathology, University of Würzburg, Josef-Schneider-Str. 2 97080 Würzburg, Germany Email:Rosenwald{at}mail.uni-wuerzburg.de
Background: Burkitts lymphoma is an aggressive B-cell lymphoma characterized by typical morphological, immunophenotypic and molecular features. Gene expression profiling provided a molecular signature of Burkitts lymphoma, but also demonstrated that a subset of aggressive B-cell lymphomas not fulfilling the current World Health Organization criteria for the diagnosis of Burkitts lymphoma nonetheless show a molecular signature of Burkitts lymphoma (discrepant Burkitts lymphoma). Given the different treatment of Burkitts lymphoma and diffuse large B-cell lymphomas we investigated molecular differences within gene expression-defined Burkitts lymphoma.
Design and Methods: We studied tumors from 51 Burkitts lymphoma patients, comprising 26 with classic Burkitts lymphoma, 17 with atypical Burkitts lymphoma and 8 with discrepant Burkitts lymphoma, by comparative genomic hybridization and gene expression profiling.
Results: Classic and atypical Burkitts lymphoma (excluding discrepant Burkitts lymphoma), in adult and pediatric cases do not differ in underlying genomic imbalances or gene expression suggesting that these subgroups are molecularly homogeneous. Discrepant Burkitts lymphoma, however, differ dramatically in the absolute number of alterations from classic/atypical Burkitts lymphoma and from diffuse large B-cell lymphoma. Moreover, this category includes lymphomas that carry both the t(14;18) and t(8;14) translocations and are clinically characterized by presentation in adult patients and an aggressive course.
Conclusions: Pediatric and adult Burkitts lymphoma are molecularly homogeneous, whereas discrepant Burkitts lymphoma differ in underlying genetic and clinical features from typical/atypical Burkitts lymphoma. Discrepant Burkitts lymphoma may therefore form a distinct genetic subgroup of aggressive B-cell lymphomas, which show poor response to multi-agent chemotherapy.
Key words: Burkitts lymphoma, comparative genomic hybridization, DLBCL, gene expression.
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