PP60. PERSISTENT POLYCLONAL B-CELL LYMPHOCYTOSIS: HIGH-RISK TRANSFORMATION TO LYMPHOMA. CYTOGENETIC AND MOLECULAR STUDY OF 34 CASES
STAVROULA KOKKINOU, ,C.Tzanidakis, A.Lindou, H.Alafaki, R.Hatzikyriakou, G.Floropoulou, A.Haralambopoulou, E.Fakiri, K.Pavlou, Cytogenetic Unit, Sismanoglion General Hospital, Athens, Greece. e-mail: sismlibr@hotmail.com
*Corresponding Author:
page: 74

Abstract

Persistent polyclonal B-lymphocytosis (PPBL) is a rare disorder affecting young to middle-aged women, characterized.by increased number of circulating polyclonal B-lymphocytes. The aim is to show that there is a genetic substrate and that causative factors can transform a benign condition to a malignant one.

In the study are included 34 patients (M/F:17/17),17-65y old. The longer lymphocytosis exists 16 years. Physical examination, complete blood count, blood smear examination for binucleated lymphocytes, serum immunoglobulin levels, flow cytometry analysis and EBV, CMV antibodies (ELISA) was done. PB lymphocytes were cultured and were TPA/LPS stimulated. Metaphases were GTG banded. Thirty metaphases were analyzed (ISCN1995).FISH was performed on metaphase chromosomes using the LSI IGH/MYC, CEP 8, Tricolor, and LSI IGH/BCL2 dual color probe (VYSIS).

Five hundred interphase nuclei were analyzed for each patient.

The karyotypes looked normal. FISH revealed extra copies of IGH gene in all, extra copies of BCL2 in8 F/9 M pts, and extra C-myc oncogene in 5pts. We confirmed the presence of t(14;18) in17 pts. Ten pts still have IgM type antibodies forEBV/CMV.

1) In our group the ratio M/F is equal with no predominance of the female pts.

2) The absence of a cytogenetic clonal population suggests the polyclonal nature of B lymphocytosis. The presence of t(14;18) demonstrate the possibility of a transformation to lymphoma under certain conditions such as EBV/ CMV chronic infection.

3) The occurrence of PPBL within the families ascertains itís familial occurrence and suggests a hereditary/genetic profile of the syndrome.

4) It is remarkable the presence of young pts with PPBL.

5) The PPBL pts who have multiple IgH/BCL2 gene rearrangements, phenomenon  associated with genetic instability can get a lymphoma due to chronic EBV/CMV infection.




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