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IgV H mutations in blastoid mantle cell lymphoma characterize a subgroup with a tendency to more favourable clinical outcome
Author(s) -
Cogliatti Sergio B,
Bertoni Francesco,
Zimmermann Dieter R,
Henz Samuel,
Diss Tim C,
Ghielmini Michele,
Schmid Ulrico
Publication year - 2005
Publication title -
the journal of pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.964
H-Index - 184
eISSN - 1096-9896
pISSN - 0022-3417
DOI - 10.1002/path.1781
Subject(s) - blastoid , mantle cell lymphoma , lymphoma , biology , survival analysis , medicine , immunology
Mantle cell lymphoma (MCL) is associated with a very unfavourable clinical course. This is particularly true for mantle cell lymphoma of the blastoid subtype (MCL‐b). In order to define prognostic factors, we analysed the impact of immunoglobulin heavy chain variable ( IgV H ) gene somatic hypermutations on clinical outcome in a series of 21 cases of morphologically, phenotypically, and genotypically well‐characterized MCL‐b. Testing and estimation were performed using log‐rank statistics and displayed on Kaplan–Meier graphs. Thirteen of 21 cases of MCL‐b revealed a homology rate of ≥99% compared to IgV H germ‐line sequences in the databases and were scored as non‐mutated. Eight of 21 cases (38%) of MCL‐b were mutated. In MCL‐b the mutation frequency was usually low and the mutation pattern was only rarely antigen‐selected, in contrast to a control group of 11 cases with morphologically almost identical, but phenotypically and genotypically clearly distinguishable, diffuse large B cell lymphoma, derived, most likely, from germinal centre B cells. In our series of 21 MCL‐b, positive IgV H mutational status, irrespective of varying homology thresholds, had no statistically significant prognostic impact on event‐free or overall survival. However, mutated MCL‐b tended to present more frequently at an earlier stage and without bone marrow involvement and to show lower rates of relapse and death, resulting in a more favourable clinical outcome. Copyright © 2005 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.