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Diffuse large B-cell lymphoma in Chinese patients: immunophenotypic and cytogenetic analyses of 124 cases
Yan Chen1, Tao Han, Javeed Iqbal
1Department of Pathology, Shanghai Cancer Hospital and Institute, Fudan University School of Medicine, Shanghai, China.
Insights
Chinese diffuse large B-cell lymphoma (DLBCL) cases show less frequent GCB subtype and t(14;18) translocation but higher BCL2 overexpression than Western cases. BCL2 expression correlates with 18q gain and notably 3q gain in Chinese DLBCL.
Area of Science:
- Oncology
- Hematology
- Genetics
Background:
- Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease with distinct subtypes.
- BCL2 expression is a key marker in DLBCL, often linked to specific genetic alterations like t(14;18) translocation or 18q gain.
- Previous studies suggest ethnic variations in DLBCL subtypes, particularly the germinal center B-cell (GCB) subtype.
Purpose of the Study:
- To investigate ethnic differences in DLBCL subtypes and BCL2 expression patterns between Chinese and Western populations.
- To analyze the correlation of BCL2 expression with genetic alterations, including chromosomal gains and translocations, in Chinese DLBCL cases.
Main Methods:
- Immunohistochemistry, conventional cytogenetics, and interphase fluorescence in situ hybridization (FISH) were used.
- Analysis of 124 Chinese DLBCL cases and comparison with a cohort of 114 Western DLBCL cases.
- Statistical analysis to compare incidences and correlations between the cohorts.
Main Results:
- Chinese DLBCL cases exhibited significantly lower incidences of the GCB subtype and t(14;18) translocation compared to Western cases.
- BCL2 overexpression was found to be more frequent in Chinese DLBCL cases than in Western cases.
- BCL2 expression correlated with gain of chromosome 18/18q in both ethnic groups, and notably with gain of chromosome 3/3q in the Chinese cohort.
Conclusions:
- Significant ethnic disparities exist in the molecular and genetic landscape of DLBCL between Chinese and Western populations.
- BCL2 overexpression in Chinese DLBCL is associated with distinct genetic alterations, including 18q gain and a novel association with 3q gain.
- These findings highlight the importance of considering ethnic background in understanding DLBCL pathogenesis and potential therapeutic strategies.
Abstract:
In diffuse large B-cell lymphoma (DLBCL), BCL2 expression usually correlates with the t(14;18) (q32;q21) in germinal center B-cell (GCB) subtype and with gain/amplification of chromosome 18q21 in the activated B cell-like subtype. Studies have suggested that the GCB subtype is less common in Chinese than in Western populations. We studied 124 Chinese DLBCL cases using immunohistochemical, conventional cytogenetics, and interphase fluorescence in situ hybridization analyses. A cohort of 114 well-characterized DLBCL cases from Western populations was also analyzed for comparison. Lower incidences of the GCB subtype (P = .0001) and the t(14;18) translocation (P = .0001) were present in Chinese cases. However, BCL2 overexpression was more frequent in Chinese compared with Western cases (P = .0054). BCL2 expression was associated with gain of chromosome 18/18q in the Chinese and Western cohorts. More interestingly, BCL2 expression was associated with gain of chromosome 3/3q in Chinese DLBCL cases, whereas this association was less significant in Western cases.