Prognostic significance of bcl-xL gene expression and apoptotic cell counts in follicular lymphoma

• Published in: Blood Vol. 103; no. 2; pp. 695 - 697
• Main Authors: Zhao, Wei-Li, Daneshpouy, Marjan Ertault, Mounier, Nicolas, Brière, Josette, Leboeuf, Christophe, Plassa, Louis-François, Turpin, Elisabeth, Cayuela, Jean-Michel, Ameisen, Jean-Claude, Gisselbrecht, Christian, Janin, Anne
• Format: Journal Article
• Language: English
• Published: Washington, DC Elsevier Inc 15.01.2004; The Americain Society of Hematology
• Subjects: Adult; Aged; Aged, 80 and over; Apoptosis - genetics; bcl-X Protein; Biological and medical sciences; Female; Gene Expression Regulation, Neoplastic - genetics; Hematologic and hematopoietic diseases; Humans; In Situ Nick-End Labeling; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymph Node Excision; Lymphoma, Follicular - genetics; Lymphoma, Follicular - mortality; Lymphoma, Follicular - pathology; Male; Medical sciences; Middle Aged; Prognosis; Proto-Oncogene Proteins c-bcl-2 - genetics; Reverse Transcriptase Polymerase Chain Reaction; Survival Analysis; Time Factors; Human; Prognosis; Lymphoproliferative syndrome; Follicular lymphoma; Malignant hemopathy; Non Hodgkin lymphoma; Gene expression
• ISSN: 0006-4971; 1528-0020; 1528-0020
• DOI: 10.1182/blood-2003-06-1901

bcl-xL, a member of the Bcl-2 family, exerts an antiapoptotic effect on lymphocytes. To assess its clinical significance in patients with follicular lymphoma, realtime quantitative reverse transcription–polymerase chain reaction (RT-PCR) analysis of bcl-xL gene expression was investigated in whole lymph node sections and laser-microdissected lymphoma cells of 27 patients. Compared with 10 patients with reactive follicular hyperplasia, the bcl-xL gene was overexpressed in patients with follicular lymphoma at a higher level in microdissected lymphoma cells. The bcl-xL gene level correlated with the number of apoptotic lymphoma cells labeled by terminal deoxytransferase-catalyzed DNA nick-end labeling (TUNEL) assays (r = -0.7736). Clinically, a high bcl-xL level was significantly associated with multiple sites of extranodal involvement (P = .0020), elevated lactate dehydrogenase level (P = .0478), and an International Prognostic Index indicating high risk (P = .0235). Moreover, bcl-xL gene overexpression was linked to short overall survival times (P = .0129). The value of bcl-xL gene expression as a prognostic marker in follicular lymphoma should thus be considered.