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Prognostic value of chromosomal abnormalities in follicular lymphoma
H Tilly, A Rossi, A Stamatoullas, B Lenormand, C Bigorgne, A Kunlin, M Monconduit and C Bastard
Department of Clinical Hematology, Centre Henri Becquerel, Rouen, France.
The t(14;18)(q32;q21) chromosomal translocation is observed in more than
75% of cases of follicular lymphoma. Several additional chromosomal
abnormalities, which might contribute to tumor progression, have also been
described. However, prognostic implications of cytogenetic features in
follicular lymphoma have not been clearly established. In an attempt to
correlate cytogenetic findings with clinical outcome, we have studied
survival and risk of transformation into a more aggressive lymphoma in 66
follicular lymphoma patients from whom a lymph node had been karyotyped at
the time of diagnosis. A t(14;18) was the most common abnormality, having
been observed in 51 patients (77%), but this showed no correlation with
clinical outcome. Seventeen other recurrent numerical or structural
abnormalities were identified in more than 10% of the patients. A high
percentage of cells (> or = 90%) with abnormal metaphases and a number
of chromosomal breaks higher than 6 were associated with a poor survival (P
> .01 each). Patients with an abnormality of chromosome region 1p21-22
(P < .01), of 6q23-26 (P < .001), or of the short arm of chromosome
17 (P < .001) had a significantly shorter survival in univariate
analysis. Multivariate analysis identified a break at 6q23-26 (P = .01) and
17p (P = .01) as independent prognostic factors in this population. The
risk of transformation into a diffuse large-cell lymphoma was significantly
higher in patients with either a 6q23-26 (P < .001) or a 17p (P <
.01) abnormality. Chromosomal analysis of follicular lymphoma at the time
of diagnosis can thus provide important information about the risk of
transformation and survival.(ABSTRACT TRUNCATED AT 250 WORDS)
Volume 84,
Issue 4,
pp. 1043-1049,
08/15/1994
Copyright © 1994 by The American Society of Hematology
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