Molecular Diagnosis of Burkitt's Lymphoma
- Dave, Sandeep S.
- Fu, Kai
- Wright, George W.
- Lam, Lloyd T.
- Kluin, Philip
- Boerma, Evert-Jan
- Greiner, Timothy C.
- Weisenburger, Dennis D.
- Rosenwald, Andreas
- Ott, German
- Muller-Hermelink, Hans-Konrad
- Gascoyne, Randy D.
- Delabie, Jan
- Rimsza, Lisa M.
- Braziel, Rita M.
- Grogan, Thomas M.
- Campo, Elias
- Jaffe, Elaine S.
- Dave, Bhavana J.
- Sanger, Warren
- Bast, Martin
- Vose, Julie M.
- Armitage, James O.
- Connors, Joseph M.
- Smeland, Erlend B.
- Kvaloy, Stein
- Holte, Harald
- Fisher, Richard I.
- Miller, Thomas P.
- Montserrat, Emilio
- Wilson, Wyndham H.
- Bahl, Manisha
- Zhao, Hong
- Yang, Liming
- Powell, John
- Simon, Richard
- Chan, Wing C.
- Staudt, Louis M.
Background
The distinction between Burkitt's lymphoma and diffuse large-B-cell lymphoma is crucial because these two types of lymphoma require different treatments. We examined whether gene-expression profiling could reliably distinguish Burkitt's lymphoma from diffuse large-B-cell lymphoma.
Methods
Tumor-biopsy specimens from 303 patients with aggressive lymphomas were profiled for gene expression and were also classified according to morphology, immunohistochemistry, and detection of the t(8;14) c-myc translocation.
Results
A classifier based on gene expression correctly identified all 25 pathologically verified cases of classic Burkitt's lymphoma. Burkitt's lymphoma was readily distinguished from diffuse large-B-cell lymphoma by the high level of expression of c-myc target genes, the expression of a subgroup of germinal-center B-cell genes, and the low level of expression of major-histocompatibility-complex class I genes and nuclear factor-(kappa)B target genes. Eight specimens with a pathological diagnosis of diffuse large-B-cell lymphoma had the typical gene-expression profile of Burkitt's lymphoma, suggesting they represent cases of Burkitt's lymphoma that are difficult to diagnose by current methods. Among 28 of the patients with a molecular diagnosis of Burkitt's lymphoma, the overall survival was superior among those who had received intensive chemotherapy regimens instead of lower-dose regimens.
Conclusions
Gene-expression profiling is an accurate, quantitative method for distinguishing Burkitt's lymphoma from diffuse large-B-cell lymphoma.
N Engl J Med 2006;354
2431-42.