bcl-2 Rearrangements in de novo diffuse large cell lymphoma. Association with distinctive clinical features

Abstract

Background. The frequency and clinical significance of bcl‐2 rearrangement in de novo B‐cell diffuse large cell lymphoma is largely unknown. Methods. Using Southern blot hybridization and multiple DNA probes, the status of the protooncogene bcl‐2 was investigated in frozen tissue samples from 45 carefully selected cases of de novo diffuse large cell lymphoma of B‐cell origin. Results were correlated with the presenting clinical and immunophenotypic features and with the subsequent clinical course. Results. Rearrangements of bcl‐2 were identified in nine tumor specimens (20%). The bcl‐2‐positive cases more often presented as early‐stage, nonmucosal associated extranodal tumors (P = 0.06) and were more often HLA‐DR negative (P = 0.07). Five‐year failure‐free survival was poor among the bcl‐2‐positive cases (11% versus 48%). Overall survival was no different, however, because relapses in bcl‐2‐positive cases tended to be responsive to further therapy. Conclusions. Analysis of bcl‐2 rearrangements in de novo diffuse large cell lymphoma may identify a subset of patients with unusual clinical features. Cancer 1993; 72:231–6.