Study Of Cytogenetic Aberrations And Its Clinical Significance In Diffuse Large B-cell Lymphoma With Bone Marrow Involvement

Objective:To study the cytogenetic features of diffuse large B cell lymphoma(DLBCL) with bone marrow involvement(BMI),and combined with clinical materials,to explore the relationship between cytogenetic aberration and clinical features and its prognostic value.Method:1. The caryotype of55DLBCL patients with BMI were analysed using conventional cytogenetic(CC).2. The gene of IgH,Rb1,D13S25,P53, ATM、Bcl-2、Bcl-6、c-MYC of18patients were detected by fluorescence in situ hybridization(FISH).3. We summarise the clinical data and explore the relationship between cytogenetic aberration and clinical features and its prognostic value.Reults:1. Chromosome aberrations(CA) were detected in34of55petionts(61.8%) by CC,including complex aberrations21cases and highly complex aberrations14cases.2.18cases were detected with FISH and8cases were positive for the Bcl-2amplication,2cases for the t(14;18) aberration,7cases for IgH,5for Bcl-6amplication,5for P53deletion,3for D13S25deletion,2for Rb-1deletion and4cases for c-MYC amplication.3.3cases with normal caryotypes by CC had abnormal cytogenetic by FISH.The statistic analysis showed that the sensibility and specificity of FISH is obviously superior to CC(P=0.007).4. The clinical characteristics of age<60,serum albuminal<35g/L,more than two extranodal sites involvement.moderate and severe BMI were more prevalent in patients with abnormal cytogenetics than in those with normal ones.5. Univariate analysis showed that hepotomegaly,splenomegaly, serum albuminal<35g/L,moer than two extranodal sites involvement,moderate and severe BMI,abnormal cytogenetic and CA of chromosomes1,2,3,6,13,17and18,del(P53),t(14;18),IgH translocation,amplycation of c-MYC and BCL-2were associated with shorter OS and PFS.Abnormal cytogenetic and CA of chromosomes12,17were associated with shorter OS, abnormal cytogenetic and CA of chromosomes20was associated with shorter PFS.Multiple analysis showed that splenomegaly, moderate and severe BMI were independent prognostic factors for OS and PFS, CA of chromosome17were independent prognostic factors for OS of DLBCL with BMI.Conclusion:1. The detection rate of DLBL with BMI was high and every chromosome can be involved.2. The sensibility and specificity of FISH is obviously superior to CC.3. Compared with patients with normal cytogenetic,the abnormal ones are more aggressive in the clinical behaviour.4. Splenomegaly and moderate and severe BMI were adverse factors for PFS and OS,while CA of chromosome17was independent prognostic factor for PFS.