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.
New England Journal of Medicine 354(23):p 2431-2442, June 8, 2006.

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.

Copyright © 2006 Massachusetts Medical Society. All rights reserved.
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