Yazarlar : ROCHESTER, Minn

Yayın : DGNews

Yayın Yılı : 2014

Pubmed Linki : http://www.docguide.com/mayo-clinic-recommends-new-routine-testing-some-non-hodgkin-lymphomas?tsid=5

Konu : Lenfoma

Literatür İçeriği :  ROCHESTER, Minn -- June 27, 2014 -- Researchers has discovered 3 subgroups of a single type of non-Hodgkin lymphoma that have markedly different survival rates.

These subgroups could not be differentiated by routine pathology but only with the aid of novel genetic tests, which the research team recommends giving to all patients with ALK-negative anaplastic large-cell lymphoma (ALCL).

Their findings are published in the journal Blood.

Patients whose lymphomas had TP63 rearrangements had only a 17% chance of living 5 years beyond diagnosis, compared with 90% of patients whose tumours had DUSP22 rearrangements. A third group of tumours, those with neither rearrangement, was associated with an intermediate survival rate.

“This is the first study to demonstrate unequivocal genetic and clinical heterogeneity among systemic ALK-negative anaplastic large-cell lymphomas,” said Andrew L. Feldman, MD, Mayo Clinic, Rochester, Minnesota. “Most strikingly, patients with DUSP22-rearranged ALCL had excellent overall survival rates, while patients with TP63-rearranged ALCL had dismal outcomes and nearly always failed standard therapy.”

ALCL comprises about 3% of all non-Hodgkin lymphoma and 10% to 30% of all cases in children. Currently, all ALK-negative anaplastic large-cell lymphomas are treated the same, using chemotherapy and, in some institutions, stem cell transplantation. Results from the study make a clear case for additional testing and possible changes standard of care.

“This is a great example of where individualised medicine can make a difference,” said Dr. Feldman. “Patients whose chances of surviving are 1 in 6 are receiving the same therapy as patients whose odds are 9 in 10. Developing tests that identify how tumours are different is a critical step toward being able to tailor therapy to each individual patient.”

TP63 and DUSP22 rearrangements are examples of abnormal swapping of DNA that disturbs the way genes are arranged on a tumour cell’s chromosomes. These abnormalities cannot be seen in the standard microscopic evaluation that pathologists use to diagnose lymphoma, but can be visualised using fluorescence in situ hybridisation (FISH). The authors of the study recommend performing FISH in all patients with ALK-negative anaplastic large-cell lymphoma.

More information on the new tests can be found here:

• 6p25.3 FISH (DUSP22/IRF4): http://www.mayomedicallaboratories.com/test-catalog/Overview/60506

• 3q28 FISH (TP63): http://www.mayomedicallaboratories.com/test-catalog/Overview/70014

SOURCE: Mayo Clinic

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