Interphase fluorescence in situ hybridization with an IGH probe is important in the evaluation of patients with a clinical diagnosis of chronic lymphocytic leukaemia

Grzegorz S Nowakowski, G. W. Dewald, James Hoyer, S. F. Paternoster, K. J. Stockero, S. R. Fink, S. A. Smoley, Ellen McPhail, R. L. Phyliky, T. G. Call, T. D. Shanafelt, Neil Elliot Kay, Clive S. Zent

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Abstract

Translocations involving IGH are common in some lymphoid malignancies but are believed to be rare in chronic lymphocytic leukaemia (CLL). To study the clinical utility of fluorescence in situ hybridization (FISH) for IGH translocations, we reviewed 1032 patients with a presumptive diagnosis of CLL. Seventy-six (7%) patients had IGH translocations. Pathology and clinical data were available for the 24 patients evaluated at the Mayo Clinic. Ten (42%) patients had IGH/cyclin D1 fusion and were diagnosed with mantle cell lymphoma (MCL). The immunophenotype was typical of MCL in three of these patients and atypical for MCL in seven patients. One patient had biclonal disease with typical MCL and CLL with IGH/BCL-2. Eleven (46%) patients had IGH/BCL-2 fusion including the patient with biclonal disease. Two of these patients had leukaemic phase follicular lymphoma and nine patients had CLL. The median progression-free survival of patients with CLL and IGH/BCL-2 translocation was 20-6 months. The two patients with IGH/BCL-3 fusion (one of these also had IGH/BCL-11a) had rapid disease progression. The IGH partner gene was not identified in two patients. We conclude that use of an IGH probe in FISH analysis of monoclonal B-cell lymphocytosis improves diagnostic precision and could have prognostic value in patients with CLL.

Original languageEnglish (US)
Pages (from-to)36-42
Number of pages7
JournalBritish Journal of Haematology
Volume130
Issue number1
DOIs
StatePublished - Jul 2005

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Interphase
B-Cell Chronic Lymphocytic Leukemia
Fluorescence In Situ Hybridization
Mantle-Cell Lymphoma
Lymphocytosis
Follicular Lymphoma
Clinical Pathology
Cyclin D1
Disease-Free Survival
Disease Progression

Keywords

  • BCL-2
  • CLL
  • FISH
  • IGH
  • Translocations

ASJC Scopus subject areas

  • Hematology

Cite this

Interphase fluorescence in situ hybridization with an IGH probe is important in the evaluation of patients with a clinical diagnosis of chronic lymphocytic leukaemia. / Nowakowski, Grzegorz S; Dewald, G. W.; Hoyer, James; Paternoster, S. F.; Stockero, K. J.; Fink, S. R.; Smoley, S. A.; McPhail, Ellen; Phyliky, R. L.; Call, T. G.; Shanafelt, T. D.; Kay, Neil Elliot; Zent, Clive S.

In: British Journal of Haematology, Vol. 130, No. 1, 07.2005, p. 36-42.

Research output: Contribution to journalArticle

Nowakowski, Grzegorz S ; Dewald, G. W. ; Hoyer, James ; Paternoster, S. F. ; Stockero, K. J. ; Fink, S. R. ; Smoley, S. A. ; McPhail, Ellen ; Phyliky, R. L. ; Call, T. G. ; Shanafelt, T. D. ; Kay, Neil Elliot ; Zent, Clive S. / Interphase fluorescence in situ hybridization with an IGH probe is important in the evaluation of patients with a clinical diagnosis of chronic lymphocytic leukaemia. In: British Journal of Haematology. 2005 ; Vol. 130, No. 1. pp. 36-42.
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AU - Dewald, G. W.

AU - Hoyer, James

AU - Paternoster, S. F.

AU - Stockero, K. J.

AU - Fink, S. R.

AU - Smoley, S. A.

AU - McPhail, Ellen

AU - Phyliky, R. L.

AU - Call, T. G.

AU - Shanafelt, T. D.

AU - Kay, Neil Elliot

AU - Zent, Clive S.

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AB - Translocations involving IGH are common in some lymphoid malignancies but are believed to be rare in chronic lymphocytic leukaemia (CLL). To study the clinical utility of fluorescence in situ hybridization (FISH) for IGH translocations, we reviewed 1032 patients with a presumptive diagnosis of CLL. Seventy-six (7%) patients had IGH translocations. Pathology and clinical data were available for the 24 patients evaluated at the Mayo Clinic. Ten (42%) patients had IGH/cyclin D1 fusion and were diagnosed with mantle cell lymphoma (MCL). The immunophenotype was typical of MCL in three of these patients and atypical for MCL in seven patients. One patient had biclonal disease with typical MCL and CLL with IGH/BCL-2. Eleven (46%) patients had IGH/BCL-2 fusion including the patient with biclonal disease. Two of these patients had leukaemic phase follicular lymphoma and nine patients had CLL. The median progression-free survival of patients with CLL and IGH/BCL-2 translocation was 20-6 months. The two patients with IGH/BCL-3 fusion (one of these also had IGH/BCL-11a) had rapid disease progression. The IGH partner gene was not identified in two patients. We conclude that use of an IGH probe in FISH analysis of monoclonal B-cell lymphocytosis improves diagnostic precision and could have prognostic value in patients with CLL.

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