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A subset of t(11;14) lymphoma with mantle cell features displays mutated IgVH genes and includes patients with good prognosis, nonnodal disease

A subset of t(11;14) lymphoma with mantle cell features displays mutated IgVH genes and includes patients with good prognosis, nonnodal disease
A subset of t(11;14) lymphoma with mantle cell features displays mutated IgVH genes and includes patients with good prognosis, nonnodal disease
We analyzed lymphocyte morphology, histology, immunophenotype, immunoglobulin heavy chain (IgVH) gene mutations, and clinical course in 80 unselected patients presenting with circulating t(11;14) lymphocytes. Of the 80 patients, 43 had peripheral lymphadenopathy (nodal group), and histology confirmed mantle cell lymphoma (MCL) in all. There were 37 patients with no lymphadenopathy (nonnodal group); 13 of 37 had histology, all showing MCL. IgVH genes were unmutated in 28 (90%) of 31 nodal and 15 (44%) of 34 nonnodal cases (P = .0001); CD38 was positive in 32 (94%) of 34 nodal and 16 (48%) of 33 nonnodal cases (P < .001); 41 (95%) of 43 nodal patients required immediate treatment compared with 18 (49%) of 37 nonnodal patients who had indolent disease (P < .0001). Median survival (95% confidence interval) was 30 months (10-50) in the nodal group and 79 months (22-136) in the nonnodal group (P = .005). Mutation status did not statistically affect survival, but of 6 long-term survivors (> 90 months) all were nonnodal and 5 of 5 had mutated IgVH genes. Lymphocyte morphology was heterogeneous in both groups: typical MCL in 56 cases (34 nodal, 22 nonnodal), blastoid MCL in 8 cases (3 nodal, 5 nonnodal), and small-cell MCL in 16 cases (6 nodal, 10 nonnodal, P = .12). Matutes immunophenotyping score was 1 in 65 cases and 2 in 15 (8 nodal, 7 nonnodal). We find no evidence against a diagnosis of MCL in the nonnodal group and suggest that mutated IgVH genes may help identify patients with indolent disease.
0006-4971
4975-4981
Orchard, Jenny
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Garnd, Richard
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Davis, Zadie
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Babbage, Gavin
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Sahota, Surinder
66c1457f-cba2-4c49-9c8c-fcee0748b6b8
Matutes, Estella
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Catovsky, Daniel
0c2a5c78-d841-456e-88c7-581850d4e80a
Thomas, Peter W.
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Avet-Loiseau, Hervé
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Oscier, David
2e7f0cc1-93e2-441e-857d-7314efae08ec
Orchard, Jenny
2b495100-85dc-4467-82c2-39b66c6f5bd7
Garnd, Richard
698be3d6-157e-42a0-8c92-2f691e7bb48d
Davis, Zadie
ea848a46-b564-448f-b77f-840d86b3cbd9
Babbage, Gavin
d2036377-f36a-4a4a-8634-4b0394dffe28
Sahota, Surinder
66c1457f-cba2-4c49-9c8c-fcee0748b6b8
Matutes, Estella
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Catovsky, Daniel
0c2a5c78-d841-456e-88c7-581850d4e80a
Thomas, Peter W.
170872d9-476f-451f-b32d-c19bd6058de6
Avet-Loiseau, Hervé
98a33e09-4476-4de7-9c7f-440198a1a183
Oscier, David
2e7f0cc1-93e2-441e-857d-7314efae08ec

Orchard, Jenny, Garnd, Richard, Davis, Zadie, Babbage, Gavin, Sahota, Surinder, Matutes, Estella, Catovsky, Daniel, Thomas, Peter W., Avet-Loiseau, Hervé and Oscier, David (2003) A subset of t(11;14) lymphoma with mantle cell features displays mutated IgVH genes and includes patients with good prognosis, nonnodal disease. Blood, 101 (12), 4975-4981. (doi:10.1182/blood-2002-06-1864).

Record type: Article

Abstract

We analyzed lymphocyte morphology, histology, immunophenotype, immunoglobulin heavy chain (IgVH) gene mutations, and clinical course in 80 unselected patients presenting with circulating t(11;14) lymphocytes. Of the 80 patients, 43 had peripheral lymphadenopathy (nodal group), and histology confirmed mantle cell lymphoma (MCL) in all. There were 37 patients with no lymphadenopathy (nonnodal group); 13 of 37 had histology, all showing MCL. IgVH genes were unmutated in 28 (90%) of 31 nodal and 15 (44%) of 34 nonnodal cases (P = .0001); CD38 was positive in 32 (94%) of 34 nodal and 16 (48%) of 33 nonnodal cases (P < .001); 41 (95%) of 43 nodal patients required immediate treatment compared with 18 (49%) of 37 nonnodal patients who had indolent disease (P < .0001). Median survival (95% confidence interval) was 30 months (10-50) in the nodal group and 79 months (22-136) in the nonnodal group (P = .005). Mutation status did not statistically affect survival, but of 6 long-term survivors (> 90 months) all were nonnodal and 5 of 5 had mutated IgVH genes. Lymphocyte morphology was heterogeneous in both groups: typical MCL in 56 cases (34 nodal, 22 nonnodal), blastoid MCL in 8 cases (3 nodal, 5 nonnodal), and small-cell MCL in 16 cases (6 nodal, 10 nonnodal, P = .12). Matutes immunophenotyping score was 1 in 65 cases and 2 in 15 (8 nodal, 7 nonnodal). We find no evidence against a diagnosis of MCL in the nonnodal group and suggest that mutated IgVH genes may help identify patients with indolent disease.

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Published date: 2003

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Local EPrints ID: 26502
URI: http://eprints.soton.ac.uk/id/eprint/26502
ISSN: 0006-4971
PURE UUID: 7bce44df-9714-489c-9066-d8ad902f9f3a

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Date deposited: 19 Apr 2006
Last modified: 15 Mar 2024 07:11

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Contributors

Author: Jenny Orchard
Author: Richard Garnd
Author: Zadie Davis
Author: Gavin Babbage
Author: Surinder Sahota
Author: Estella Matutes
Author: Daniel Catovsky
Author: Peter W. Thomas
Author: Hervé Avet-Loiseau
Author: David Oscier

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