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Blastoid variant of mantle cell lymphoma: late progression from classical mantle cell lymphoma and quantitation of minimal residual disease.
- Source :
- European Journal of Haematology; Apr2005, Vol. 74 Issue 4, p353-358, 6p
- Publication Year :
- 2005
-
Abstract
- Pott C, Schrader C, Brüggemann M, Ritgen M, Harder L, Raff T, Tiemann M, Dreger P, Kneba M. Blastoid variant of mantle cell lymphoma: late progression from classical mantle cell lymphoma and quantitation of minimal residual disease.Eur J Haematol 2005: 74: 353–358.© Blackwell Munksgaard 2005.Objectives: Classical mantle cell lymphoma (MCL) and its blastoid variant (MCL-BV) are characterized by an extremely poor prognosis. Long-time survivors are rare, only very few patients with an overall survival over 10 years have been reported. We present a case of a 41-year-old male with a 12 yr history of MCL stage I to show, that very late relapses in MCL are possible and may present as a transformation into an aggressive blastoid variant and to illustrate the value of quantitative minimal residual disease (MRD) monitoring for treatment guidance.Methods: Diagnostic lymph node and bone marrow samples were investigated by immunohistochemistry. Clonality analysis was performed by immunoglobulin heavy chain gene(IGVH)and t(11;14) PCR. The MRD assessment was done by real-time quantitative PCR (RQ-PCR) on available follow-up samples.Results: By histologic review and sequencing of the clonalIGVHand t(11;14) PCR products we demonstrated a common clonal origin of the leucemic MCL-BV and the classical MCL diagnosed 12 yr earlier. Quantitative MRD assessment revealed significant MRD levels after intensive conventional chemotherapy including Rituximab. Therefore, treatment was early intensified by myeloablative radio-chemotherapy and allogeneic peripheral stem cell transplantation from an unrelated HLA-identical donor. This did not translate into a sustained remission as reflected by persisting MRD levels after transplantation and the patient died from rapid progressive disease 3.5 months after transplant.Conclusion: This report presents a rare case of long-term survivor of MCL with a progression of the original MCL cell clone to MCL-BV and demonstrates the clinical value of quantitative MRD assessment for optimized therapeutic management. [ABSTRACT FROM AUTHOR]
- Subjects :
- BLASTOIDEA
BONE marrow
PHARMACOLOGY
IMMUNOHISTOCHEMISTRY
HISTOPATHOLOGY
STEM cells
Subjects
Details
- Language :
- English
- ISSN :
- 09024441
- Volume :
- 74
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- European Journal of Haematology
- Publication Type :
- Academic Journal
- Accession number :
- 16408314
- Full Text :
- https://doi.org/10.1111/j.1600-0609.2005.00409.x