objective To study the clonal evolution of domestic children with lymphoid malignancies inorder to choose the optimal method for the detection of the minimal residual disease. methods To use the PCRwhich employs 22pri...objective To study the clonal evolution of domestic children with lymphoid malignancies inorder to choose the optimal method for the detection of the minimal residual disease. methods To use the PCRwhich employs 22primers and SSCP, investigating the matched samples obtained at diagnosis and at relapse of 13children with lymphoid malignancies. Results The clonal evolution occurred in 54%, 23%, 38%, 46%, 54%, 62%and 54% of 13 cases by PCR employing IgH, TCRγ, TCRVδ2, - Dδ3, TCRPVJ1, TCRPVJ2, TCRPD1,J2, TCRβD2J2primers respectively. NO change occurred only in one of those cases. Clonal evolution at relapse occurred at 50% ofsamples which had only one band PCR product at diagnosis and 78% of those had multiple bands PCR product atdiagnosis. No differences had been detected between diagnosis and relapse by SSCP analyzing those samples inwhich no band change occurred between that at diagnosis and at relapse in PAGE. Conclusion It should beoptimal that the one band rearranged gene at diagnosis acts as main monitoring marker, simultaneously referringto the main band in multiple bands rearranged gene in order to avoid false negative.展开更多
Mature T-cell lymphoid malignancies comprise a group of heterogeneous diseases that vary in clinicopathological features, biological behavior, treatment response, and prognosis. Bone marrow （BM） infiltration is more...Mature T-cell lymphoid malignancies comprise a group of heterogeneous diseases that vary in clinicopathological features, biological behavior, treatment response, and prognosis. Bone marrow （BM） infiltration is more commonly present in mature T-cell lymphoid malignancies compared with their B-cell counterparts and hence important for differential diagnosis. In this study, clinical characteristics and prognostic factors were analyzed in 225 patients with mature T-cell lymphoid malignancies treated in a single institution. These included 29 cases of T-cell lymphoproliferative disorders （T-LPD, all with BM infiltration） and 196 cases of T-/natural-killer-cell lymphoma （T/NKCL, 56 with BM infiltration and 140 without BM infiltration）. The estimated 5-year overall survival （OS） rates of T-LPD and T/NKCL were 96.6% and 37.3%, respectively. T-LPD patients were less likely to exhibit poor performance status, advanced disease stage, presence of B symptoms, or abnormal level of serum [^-2 microglobulin. With similar pathological characteristics, T/NKCL patients with BM infiltration showed significantly lower response rates and shorter OS than those without BM infiltration （P = 0.0264 and P 〈 0.0001, respectively）. Multivariate analysis indicated that poor performance status, advanced disease stage, elevated serum lactate dehydrogenase level, and BM involvement were independent unfavorable prognostic factors. The Glasgow Prognostic Score may be more efficient than the International Prognostic Index in predicting disease outcome in T/NKCL. In conclusion, clinical characteristics may be useful in more effectively stratifying patients with mature T-cell lymphoid malignancies.展开更多
文摘objective To study the clonal evolution of domestic children with lymphoid malignancies inorder to choose the optimal method for the detection of the minimal residual disease. methods To use the PCRwhich employs 22primers and SSCP, investigating the matched samples obtained at diagnosis and at relapse of 13children with lymphoid malignancies. Results The clonal evolution occurred in 54%, 23%, 38%, 46%, 54%, 62%and 54% of 13 cases by PCR employing IgH, TCRγ, TCRVδ2, - Dδ3, TCRPVJ1, TCRPVJ2, TCRPD1,J2, TCRβD2J2primers respectively. NO change occurred only in one of those cases. Clonal evolution at relapse occurred at 50% ofsamples which had only one band PCR product at diagnosis and 78% of those had multiple bands PCR product atdiagnosis. No differences had been detected between diagnosis and relapse by SSCP analyzing those samples inwhich no band change occurred between that at diagnosis and at relapse in PAGE. Conclusion It should beoptimal that the one band rearranged gene at diagnosis acts as main monitoring marker, simultaneously referringto the main band in multiple bands rearranged gene in order to avoid false negative.
基金Acknowledgements This work was supported, in part, by the National Natural Science Foundation of China （Nos. 81172254, 81101793, and 81325003）, Innovation Fund Projects of Shanghai Jiao Tong University （No. BXJ201312）, the Shanghai Commission of Science and Technology （Nos.llJC1407300, 14430723400, and 14140903100）, and the Program of Shanghai Subject Chief Scientists （No. 13XD 1402700）.
文摘Mature T-cell lymphoid malignancies comprise a group of heterogeneous diseases that vary in clinicopathological features, biological behavior, treatment response, and prognosis. Bone marrow （BM） infiltration is more commonly present in mature T-cell lymphoid malignancies compared with their B-cell counterparts and hence important for differential diagnosis. In this study, clinical characteristics and prognostic factors were analyzed in 225 patients with mature T-cell lymphoid malignancies treated in a single institution. These included 29 cases of T-cell lymphoproliferative disorders （T-LPD, all with BM infiltration） and 196 cases of T-/natural-killer-cell lymphoma （T/NKCL, 56 with BM infiltration and 140 without BM infiltration）. The estimated 5-year overall survival （OS） rates of T-LPD and T/NKCL were 96.6% and 37.3%, respectively. T-LPD patients were less likely to exhibit poor performance status, advanced disease stage, presence of B symptoms, or abnormal level of serum [^-2 microglobulin. With similar pathological characteristics, T/NKCL patients with BM infiltration showed significantly lower response rates and shorter OS than those without BM infiltration （P = 0.0264 and P 〈 0.0001, respectively）. Multivariate analysis indicated that poor performance status, advanced disease stage, elevated serum lactate dehydrogenase level, and BM involvement were independent unfavorable prognostic factors. The Glasgow Prognostic Score may be more efficient than the International Prognostic Index in predicting disease outcome in T/NKCL. In conclusion, clinical characteristics may be useful in more effectively stratifying patients with mature T-cell lymphoid malignancies.
