NUEVOS REARREGLOS ESTRUCTURALES EN LEUCEMIA LINFOCITICA CRONICA/LINFOMA DE LINFOCITOS PEQUEÑOS

(especial para SIIC © Derechos reservados)
El trabajo informa sobre cuatro anomalías estructurales nuevas, una de ellas recurrente, y sugiere que éstas podrían implicar eventos genéticos asociadas a enfermedad inestable.
cerretini9.jpg Autor:
Roxana inés Cerretini
Columnista Experto de SIIC

Institución:
Departamento de Genética Instituto de Investigaciones Hematológicas Academia Nacional de Medicina


Artículos publicados por Roxana inés Cerretini
Coautores
Christian Pablo Chena*  Irma Rosa Slavutsky** 
Licenciado en Genética. Departamento de Genética, Instituto de Investigaciones Hematológicas “Mariano R. Castex”, Academia Nacional de Medicina.*
Doctora en Medicina. Departamento de Genética, Instituto de Investigaciones Hematológicas “Mariano R. Castex”, Academia Nacional de Medicina.**
Recepción del artículo
11 de Enero, 2005
Aprobación
14 de Febrero, 2005
Primera edición
12 de Septiembre, 2005
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
La leucemia linfocítica crónica/linfoma de linfocitos pequeños (LLC/LLP) presenta una evolución clínica muy variable, encontrándose rearreglos genómicos asociados con diferentes grupos de riesgo. Este trabajo se centra en el análisis de rearreglos estructurales de los cromosomas 2, 12 y 17; se describen 4 anomalías nuevas, detectadas en un total de 92 pacientes. Simultáneamente, se efectuó una exhaustiva revisión de la literatura. Se efectuó estudio citogenético e hibridación in situ con fluorescencia (FISH). Cuatro casos mostraron anomalías que afectaban el cromosoma 17, siendo el cromosoma 2, con punto de ruptura en 2p21, el cromosoma partner más frecuente. Un paciente presentó coexistencia de LLC/LLP con enfermedad de Hodgkin, subtipo celularidad mixta, detectándose el marcador psu dic (17;2)(p112;p21), con deleción monoalélica del gen TP53. Dos casos mostraron una nueva anomalía recurrente: t(2;17)(p21;q23), asociada a evolución clonal en ambos pacientes y a deleción 11q23 en uno de ellos. Las restantes alteraciones fueron el der(17)t(12;17)(q13;q25) y una translocación compleja t(5;12;19)(q15;p11;q13). Cuatro pacientes tuvieron curso clínico adverso y murieron debido a progresión de su enfermedad. Nuestro trabajo aporta cuatro anomalías estructurales nuevas, una de ellas recurrente, y sugiere que éstas podrían implicar eventos genéticos asociadas a enfermedad inestable.

Palabras clave
LLC/LLP, enfermedad de Hodgkin, citogenética, FISH


Artículo completo

(castellano)
Extensión:  +/-6.26 páginas impresas en papel A4
Exclusivo para suscriptores/assinantes

Abstract
Chronic lymphocytic Leukemia/small lymphocytic lymphoma (CLL/SLL) is a lymphoproliferative disorder characterized by a highly variable clinical course and specific genetic alterations have been associated with different risk groups. In the present study, we focused on the analysis of structural anomalies of chromosomes 2, 12 and 17. In addition, a exhaustive revision of the literature was performed. We identified four new genomic rearrangements detected among 92 evaluated patients. Cytogenetic studies and fluorescence in situ hybridization (FISH) analysis were performed. Four cases showed chromosome 17 structural anomalies and chromosome 2 with breakpoint at p21 was the most frequent chromosome partner. A psu dic (17;2)(p11.2;p21), leading to a TP53 deletion, was observed in a patient who developed a mixed cellularity Hodgkin’s disease coexisting with the CLL/SLL. Two cases had a new recurrent translocation t(2;17)(p21;q23), both associated with clonal evolution and one of them also with a 11q23 deletion. In addition, a der(17)t(12;17)(q13;q25) and a complex translocation t(5;12;19) (q15;p11;q13) were also found. Four patients presented an adverse clinical outcome and died due to disease progression. These uncommon abnormalities may have implications for the understanding of genetic events associated with evolving disease.

Key words
CLL/SLL, Hodgkin’s disease, cytogenetic, FISH


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Genética Humana, Hematología
Relacionadas: Diagnóstico por Laboratorio, Medicina Interna, Oncología



Comprar este artículo
Extensión: 6.26 páginas impresas en papel A4

file05.gif (1491 bytes) Artículos seleccionados para su compra




Patrocinio y reconocimiento:
Agradecimientos: Este trabajo fue realizado con subsidios otorgados por el Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), la Agencia Nacional de Promoción Científica y Técnica (ANPCyT), Fundación “Alberto J. Roemmers” y Fundación Acción Oncohematológica.
Bibliografía del artículo
  1. NHLCP: The Non-Hodgkin´s lymphoma Classification Project. A clinical evaluation of the International Lymphoma Study Group. Classification of Non-Hodgkin´s lymphoma. Blood 1997; 89: 3909-18.
  2. Klein U, Tu Y, Stolovitzky GA y col. Gene expression profiling of B cell chronic lymphocytic leukemia reveals a homogeneous phenotype related to memory B cells. J Exp Med. 2001, 194:1625-38.
  3. Rosenwald A, Alizadeh AA, Widhopf G y col. Relation of gene expression phenotype to immunoglobulin mutation genotype in B cell chronic lymphocytic leukemia. J Exp Med. 2001; 194:1639-47.
  4. Stilgenbauer S, Bullinger L, Lichter P y col. Study Group (GCLLSG). Chronic lymphocytic leukemia. Genetics of chronic lymphocytic leukemia: genomic aberrations and V(H) gene mutation status in pathogenesis and clinical course. Leukemia. 2002; 6:993-1007.
  5. Hamblin TJ, Davis Z, Gardiner A y col. Unmutated IgV genes are associated with a more aggressive form of chronic lymphocytic leukemia. Blood 1999; 94: 1848-54.
  6. Damle RN, Wasil T, Fais F y col. Ig V gene mutation status and CD38 expression as novel prognostic indicators in chronic lymphocytic leukemia. Blood. 1999; 94:1840-7.
  7. Crespo M, Bosch F, Villamor N y col. ZAP-70 expression as a surrogate for immunoglobulin-variable-region mutations in chronic lymphocytic leukemia. N Engl J Med. 2003; 348:1764-75.
  8. Del Poeta G, Maurillo L, Venditti A y col. Clinical significance of CD38 expression in chronic lymphocytic leukemia. Blood. 2001; 98: 2633-9.
  9. Ibrahim S, Keating M, Do KA y col. CD38 expression as an important prognostic factor in B-cell chronic lymphocytic leukemia. Blood. 2001; 98:181-6.
  10. Hamblin TJ, Orchard JA, Gardiner A y col. Immunoglobulin V genes and CD38 expression in CLL. Blood. 2000; 95: 2455-7.
  11. Döhner H, Stilgenbauer S, James MR y col. 11q deletions identify a new subset of B-cell chronic lymphocytic leukaemia characterized by extensive nodal involvement and inferior prognosis. Blood 1997; 89: 2516-22.
  12. Cuneo A, Bigoni R, Castoldi G. Towards a clinically relevant cytogenetic classification of chronic lymphocytic leukemia and related disorders. Haematologica. 1998; 83: 577-9.
  13. Oscier DG. Cytogenetics and molecular genetics of chronic lymphocytic leukaemia. Haematologica 1999; 84 Suppl EHA-4: 88-91.
  14. Juliusson G, Oscier DS, Fitchett M y col. Prognostic subgroups in B-cell chronic lymphocytic leukemia defined by specific chromosomal abnormalities. N Engl J Med 1990; 323: 720-24.
  15. Juliusson G, Oscier D, Gahrton G. Cytogenetic findings and survival in B-cell chronic lymphocytic leukemia. Second International Working Party on Chromosomes in CLL (IWCCLL)IWCCLL compilation of data on 662 patients. Leuk Lymphoma 1991; 5: 21-25.
  16. Juliusson G, Gahrton G. Chromosome aberrations in B-cell chronic lymphocytic leukemia: Pathogenetic and clinical implications. Cancer Genet. Cytogenet 1990; 45: 143-60.
  17. Peterson LC, Lindquist LL, Church S y col. Frequent clonal abnormalities of chromosome band 13q14 in B-cell chronic lymphocytic leukemia: multiple clones, subclones, and nonclonal alterations in 82 midwestern patients. Genes Chrom Cancer 1992; 4: 273-80.
  18. Döhner H, Stilgenbauer S, Benner A y col. Genomic aberrations and survival in chronic lymphocytic leukemia. N Eng J Med 2000; 343: 1910-6.
  19. Döhner H, Fischer K, Bentz M y col. p53 gene deletion predicts for poor survival and non-response to therapy with purine analogous in chronic B-cell leukemias. Blood 1995; 85: 1580-9.
  20. Cerretini R, Chena C, Giere I y col. Structural aberrations of chromosomes 17 and 12 in chronic B cell-disorders. Eur J Haematol 2003: 71: 433-38.
  21. Harris NL, Jaffe ES, Stein H. A revised European-American classification of lymphoid neoplasms a proposal from the Internacional Lymphoma study group. Blood 1994;84: 1361-92.
  22. Harris NL, Jaffe ES, Diebold J. World Heath Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues. Report of the clinical advisory Committee meeting-Airlie House, Virginia, November 1997. J Clin Oncol 1999; 17:3835-49.
  23. Cheson BD, Bennet JM, Grever M y col. National Cancer Institute sponsored. Working Group guidelines for chronic lymphocytic leukemia: revised guidelines for diagnosis and treatment. Blood 1996; 87: 4990-7.
  24. ISCN. An International System for Human Cytogenetic Nomenclature. Mitelman F, ed. Karger, Basel, 1995.
  25. Mitelman Database of Catalogue of Chromosome Aberrations in Cancer. 2004. Mitelman F, Johansson B, Mertens F, eds http://cgap.nci.nih.gov/Chromosomes/Mitelman.
  26. Callet-Bauchu E, Salles G, Gazzo S y col. Translocations involving the short arm of chromosome 17 in chronic B-lymphoid disorders: frequent occurrence of dicentric rearrangements and possible association with adverse outcome. Leukemia 1999; 13:460-8.
  27. Giles FJ, O´Brien SM, Keating MJ. Chronic lymphocytic leukemia in Richter´s transformation. Semin Oncol 1998; 25: 117-25.
  28. Choi H, Keller RH. Coexistence of chronic lymphocytic leukemia and Hodgkin´s disease. Cancer 1981; 48: 48-57.
  29. Butts C, Drouin J, Taylor R y col. Hodgkin´s disease in CLL. Am J Hematol 1995; 48: 134-5.
  30. Serratrice de Roux C, Coso D, Bouabdallah R y col. Chronic lymphocytic leukemia and Hodgkin´s disease. Clinicopathologic study of three cases with good prognosis. Haematologica 2000; 85: 878-9.
  31. Travis LB, Curtis RE, Hankey BF y col. Second cancers in patients with chronic lymphocybtic leukemia. J Natl Can Inst 1992; 84: 1422-7.
  32. Ohno T, Smir BN, Weisenburger DD y col. Origin of the Hodgkin/Reed-Sternberg cells in chronic lymphocytic leukemia with “Hodgkin´s transformation”. Blood 1998; 91: 1757-61.
  33. Kanzler H, Küppers R, Helmes S y col. Hodgkin and Reed-Sternberg-like cells in B-cell chronic lymphocytic leukemia represent the outgrowth of single germinal –center B-cell-derived clones: potential precursors of Hodgkin and Reed-Sternberg cells in Hodgkin´s disease. Blood 2000; 95: 1023-31.
  34. Küppers R, Sousa AB, Baur AS y col. Common germinal-center B-cell origin of the malignant cells in two composite lymphomas, involving classical Hodgkin´s disease and either follicular lymphoma of B-CLL. Mol Med 2001; 7: 285-92.
  35. Stilgenbauer S, Dohner H, Bulgay-Morschel M y col. High frequency of monoallelic retinoblastoma gene deletion in B-cell chronic lymphoid leukemia shown by interphase cytogenetics. Blood. 1993; 81: 2118-24.
  36. Finn WG, Kay NE, Kroft SH y col. Secondary abnormalities of chromosome 6q in B-cell chronic lymphocytic leukemia: a sequential study of karyotypic instability in 51 patients. Am J Hematol 1998; 59 : 223-9.
  37. Fegan C, Robinson H, Thompson P y col. Karyotypic evolution in CLL: identification of a new sub-group of patients with deletions of 11q and advanced disease. Leukemia 1995; 9: 2003-8.
  38. Cuneo A, Bigoni R, Rigolin GM y col. Late appearance of the 11q22.3-23.1 deletion involving the ATM locus in B-cell chronic lymphocytic leukemia and related disorders. Clinico-biological significance. Haematologica 2002; 87: 44-51.
  39. Haus O. The genes of interferons and interferon-related factors: localization and relationships with chromosome aberrations in cancer. Arch Immunol Ther Exp 2000; 48: 95-100.
  40. Kotoula V, Hytiroglou P, Kaloutsi V y col. Mismatch repair gene expression in malignant lymphoproliferative disorders of B-cell origin. Leuk Lymphoma 2002; 43: 393-9.
  41. Fenaux P, Preudhomme C, Lai JL y col. Mutations of the p53 gene in B-cell chronic lymphocytic leukemia: a report on 39 cases with cytogenetic analysis. Leukemia 1992, 6: 246-50.
  42. Fleischman EW, Prigogina EL, Ilynskaya GW y col. Chromosomal characteristics of malignant lymphoma.Hum Genet 1989; 82: 343-8.
  43. Juliusson G, Friberg K, Gahrton G. Consistency of chromosomal aberrations in chronic B-lymphocytic leukemia. A longitudinal cytogenetic study of 41 patients. Cancer 1988; 62: 500-6.
  44. Dierlamamm J, Wlodarska I, Michaux L y col. FISH identifies different types of duplications with 12q13-15 as the commonly involved segment in B-cell lymphoproliferative malignancies characterized by partial trisomy 12. Genes Chrom Cancer 1997; 20: 155-66.
  45. Sato Y, Kobayashi H, Suto Y y col. Chromosomal instability in chromosome band 12p13: multiple breaks leading to complex rearrangements including cytogenetically undetectable sub-clones. Leukemia. 2001: 1193-202.
  46. Ravandi F, Hayes K, Cortes J y col. Translocation t(17;18)(q10;q10): a new nonrandom chromosomal translocation of clonal evolution in chronic myeloid leukemia. Cancer. 2001; 91: 1704-8.
  47. Bird ML, Ueshima Y, Rowley JD y col. Chromosome abnormalities in B cell chronic lymphocytic leukemia and their clinical correlations. Leukemia 1989, 82: 2943-47.
  48. Cuneo A, Balboni M, Piva N y col. Atypical chronic lymphocytic leukaemia with t(11;14)(q13;q32): karyotype evolution and prolymphocytic transformation.Br J Haematol. 1995; 90: 409-16.
  49. Morris CM, Haataja L, McDonald M y col. The small GTPase RAC3 gene is located within chromosome band 17q25.3 outside and telomeric of a region commonly deleted in breast and ovarian tumors. Cytogenet Cell Genet 2000; 89: 18-23.
  50. Harada H, Nagai H, Tsuneizumi M y col. Identification of DMC1, a novel gene in the TOC region on 17q25.1 that shows loss of expression in multiple human cancers. J Hum Genet. 2001; 46: 90-5.
  51. Huang YQ, Raphael B, Buchbinder A y col. Rearrangement and expression of MDM2 oncogene in chronic lymphocytic leukemia. Am J Hematol 1994; 47: 139-41.
  52. Haidar MA, El-Hajj H, Bueso-Ramos CE y col. Expression profile of MDM-2 proteins in chronic lymphocytic leukemia and their clinical relevance. Am J Hematol 1997; 54; 189-95.
  53. Stock AD, Dennis TR: A translocation breakpoint at chromosome band 12q13 associated with B-cell chronic lymphocytic leukemia. Cancer Genet Cytogenet 1999; 111: 166-68.
  54. Gardiner AC, Corcoran MM, Oscier DG. Cytogenetic, fluorescence in situ hybridisation, and clinical evaluation of translocations with concomitant deletion at 13q14 in chronic lymphocytic leukaemia. Genes Chrom Cancer 1997; 20: 73-81.
  55. Vanderberghe E, De Wolf Peeters C, Wlodarska I y col. Chromosome 11q rearrangements in B non Hodgkin’s lymphoma. Br J Haematol 1992, 81: 212-17.
  56. Buhmann R, Kurzeder C, Rehklau J y col. CD40L stimulation enhances the ability of conventional metaphase cytogenetics to detect chromosome aberrations in B-cell chronic lymphocytic leukaemia cells. Br J Haematol 2002; 118: 968-75.
  57. Kay NE, Suen R, Ranheim E y col. Confirmation of Rb gene defects in B-CLL clones and evidence for variable predominance of the Rb defective cells within the CLL clone. Br J Haematol 1993, 84: 257-64.
  58. Michaux L, Mecucci C, Stul M y col. BCL3 rearrangement and t(14;18)(32;q21) in lymphoproliferative disorders. Genes Chrom Cancer 1996, 15: 38-47.
  59. Cuneo A, Roberti MG, Bigoni R y col. Four novel non-random chromosome rearrangements in B-cell lymphocytic leukemia: 6p24-25 and 12p12-13 translocations, 4q21 anomalies and monosomy 21. Brit J Haematol 2000; 108: 559-64.
  60. Michaux L, Dierlamm J, Wlodarska I y col. t(14;19)/BCL3 rearrangements in lymphoproliferative disorders: a review of 23 cases. Cancer Genet Cytogenet 1997, 94: 36-43.

 
 
 
 
 
 
 
 
 
 
 
 
Está expresamente prohibida la redistribución y la redifusión de todo o parte de los contenidos de la Sociedad Iberoamericana de Información Científica (SIIC) S.A. sin previo y expreso consentimiento de SIIC.
ua31618
Inicio/Home

Copyright siicsalud © 1997-2024 ISSN siicsalud: 1667-9008