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Clinical and pathological features of B-cell non-Hodgkin lymphomas lacking the surface expression of immunoglobulin

Hiromichi Matsushita1, Naoya Nakamura, Yuzo Tanaka

  • 1Department of Laboratory Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan. hmatsu@is.icc.u-tokai.ac.jp

Clinical Chemistry and Laboratory Medicine
|October 27, 2012
PubMed

Insights

Surface immunoglobulin light chain-negative B-cell non-Hodgkin lymphomas (B-NHL) often present as diffuse large B-cell lymphoma (DLBCL) in advanced stages. Rituximab-containing chemotherapy improved survival in these B-NHL cases.

Area of Science:

  • Hematology
  • Oncology
  • Immunology

Background:

  • Surface immunoglobulin light chain (sIgL) analysis is standard for evaluating monoclonal B-cell proliferation.
  • sIgL expression can be undetectable in B-cell non-Hodgkin lymphomas (B-NHL).
  • Understanding sIgL-negative B-NHL is crucial for diagnosis and treatment.

Purpose of the Study:

  • To investigate the clinical and pathological characteristics of B-NHL cases lacking sIgL expression.
  • To identify factors influencing prognosis in sIgL-negative B-NHL.
  • To evaluate treatment efficacy in this specific B-NHL subgroup.

Main Methods:

  • Retrospective analysis of 50 previously untreated sIgL-negative B-NHL cases diagnosed between 2001 and 2011.
  • Review of medical charts for clinical and pathological data.
  • Analysis of cytoplasmic IgL expression and IgL DNA rearrangement patterns in a subset of patients.

Main Results:

  • Diffuse large B-cell lymphoma (DLBCL) was the predominant subtype (72%).
  • Cases frequently presented with advanced stage (III/IV) (68%) and high lactate dehydrogenase levels (66%).
  • Rituximab-containing chemotherapy significantly improved 5-year event-free survival compared to non-rituximab regimens (57.9% vs. 17.9%, p=0.0207).

Conclusions:

  • sIgL-negative B-NHL cases are frequently DLBCL, often diagnosed at advanced stages.
  • These lymphomas exhibit molecular heterogeneity.
  • Rituximab demonstrates a survival benefit in sIgL-negative B-NHL, warranting further investigation.
Abstract

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