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Tumor Engraftment in a Xenograft Mouse Model of Human Mantle Cell Lymphoma
Published on: March 30, 2018
Blastoid and common variants of mantle cell lymphoma exhibit distinct immunophenotypic and interphase FISH features
M Parrens1, M-A Belaud-Rotureau, O Fitoussi
1Department of Pathology and Tumour Biology, CHU Bordeaux and Equipe 2406, University of Bordeaux 2, Bordeaux, France. marie.parrens@chu-bordeaux.fr
Insights
Blastoid variant mantle cell lymphoma (BV-MCL) has poorer treatment outcomes than common MCL. Phenotypic and cytogenetic markers, alongside morphology, are crucial for accurate BV-MCL diagnosis.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Mantle cell lymphoma (MCL) diagnosis relies on morphology.
- Blastoid variant MCL (BV-MCL) presents distinct clinical behavior.
- Accurate differentiation of BV-MCL is clinically significant.
Purpose of the Study:
- To analyze clinicopathological features of BV-MCL.
- To assess proliferation index, cyclin D1, and CDK4 expression in MCL subtypes.
- To evaluate interphase fluorescence in-situ hybridization (FISH) patterns in BV-MCL.
Main Methods:
- Morphological analysis of 18 MCL cases (4 BV-MCL).
- Immunohistochemistry for cyclin D1, CDK4, and MIB-1 (Ki67).
- Interphase FISH with t(11;14) and chromosome probes (11, 18, 21).
Main Results:
- BV-MCL showed shorter response duration (11 vs. 28 months) and overall survival (20 vs. 42 months) compared to common MCL.
- All MCL cases had t(11;14); BV-MCL exhibited extra CCND1 signals due to hypotetraploidy.
- BV-MCL cases displayed high cyclin D1/CDK4 expression and MIB-1 index >50%.
Conclusions:
- Morphological distinction alone is insufficient for BV-MCL recognition.
- Phenotypic and cytogenetic criteria are essential for improved BV-MCL diagnosis.
- Accurate diagnosis of BV-MCL impacts clinical management and prognosis.
Aims:
The recognition of blastoid variant (BV) of mantle cell lymphoma (MCL) is based on morphological criteria. Our aim was to analyse 18 MCL cases including four BV-MCL for their clinicopathological features, proliferation index, cyclin D1 and CDK4 expression and interphase fluorescence in-situ hybridization (FISH) pattern.
Methods And Results:
BV-MCL versus common MCL was characterized by a shorter overall duration of response after first-line therapy (11 months versus 28 months) and shorter overall survival (20 months versus 42 months). Interphase FISH showed a t(11;14) fusion pattern in all MCL tested cases. However, the four blastoid cases were characterized by extra copies of CCND1 signals. Using additional probes of chromosomes 11, 18, 21, these signals were shown to be the result of hypotetraploidy and not of a specific amplification of the normal or the translocated CCND1 allele. Moreover, the BV-MCL cases were characterized by a combined high percentage of cells expressing cyclin D1 and/or CDK4 with a proliferation (MIB-1-Ki67) index above 50%. Such features allowed the recognition of areas of large cell transformation in the case of secondary BV-MCL.
Conclusions:
Since distinction between BV and common MCL is of clinical relevance, our data underline the need to add phenotypic and cytogenetic criteria to cytomorphology for a better recognition of BV-MCL.
