The Clinical Significance Of Detecting Clonal Immuno-globulin Heavy Chain Gene Rearrangement In B Cell Lineage Neoplasms.

Paraffin-embedded biopsies from 57 patients with B cell lineage non-Hodgkin' s lymphoma (B- NHL) and stored bone marrow slides from 25 untreated patients with B-cell lineage acute lymphoblastic leukemia were analysed by polymerase chain reaction (PCR) for presence of clonal immunoglobulin heavy chain (IgH) gene rearrangements. The clonal IgH gene rearangementB were found in 81%(46/57) of the patients wiht B-NHL, in 76% (19/25) of the patients with B-ALL , but none of the 24 controls (4 of T-NHL , one of T-ALL, 8 of non-lymphoid cacinoma, 5 of reactive lymph node and 6 of normal bone marrow) . The clonal IgH gene rearrangement used as a gene marker of B-cell malignancies, a sensitive method of polymeraBe chain reaction amplification in conjunction with single - strand conformational polymorphism( PCR- SSCP) analysis was performed on the stored bone marrow slide specimens from 38 untreated patients with B-NHL and 16 patients with B-ALL in complete remission for detecting minimal disease. In the untreated patients with B-NHL, the incidence of minimal disease in bone marrow specimens was 68% (26/38). The patients with minimal disease in bone marrow had a short survival time than those of the patients without minimal disease in bone marrow (P<0. 05) . Seven of 14 patients at clincal stages I or II were found with minimal disease in bone marrow and would have been upstaged if these results were utilized for staging . In the patients with B-ALL in clincal complete remission, the incidence of minimal disease in bone marrow was 92%(11/12) in the samples taken at early period of complete remission (1-6 months ) and 44% (4/9) in samples taken at late period...