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Specificity of polymerase chain reaction‐based clonality analysis of immunoglobulin heavy chain gene rearrangement for the detection of bone marrow infiltrate in B‐cell lymphoma‐associated haemophagocytic syndrome

2002; Wiley; Volume: 119; Issue: 3 Linguagem: Inglês

10.1046/j.1365-2141.2002.03866.x

1365-2141

Kensuke Kojima, Kinuyo Kaneda, Masaki Yasukawa, Kazuo Tanaka, Takeshi Inoue, Takuya Yamashita, Hiromichi Dansako, Sumie Takase Sakugawa, Teruhiko Kozuka, Masamichi Hara, Mitsune Tanimoto,

Immunodeficiency and Autoimmune Disorders

Summary. As a wide range of disorders underlie haemophagocytic syndrome, a rapid distinction between benign polyclonal and malignant monoclonal lymphoid proliferations is critical. We investigated whether polymerase chain reaction (PCR) amplification of immunoglobulin heavy chain gene rearrangement could efficiently detect clonal B‐cell populations in non‐diagnostic marrow for B‐cell lymphoma‐associated haemophagocytic syndrome (B‐LAHS). On amplifying two DNA samples per biopsy, no reproducible monoclonal PCR result was found in reactive haemophagocytic marrows. In contrast, four out of nine assessable B‐LAHS patients with histomorphologically and immunohistochemically lymphoma‐free bone marrow showed a reproducible monoclonal immunoglobulin heavy chain gene rearrangement. At the molecular level, two B‐LAHS patients had lymphoma‐free marrow as demonstrated by patient‐specific PCR, suggesting that haemophagocytic marrow is not always associated with lymphoma involvement. PCR‐based demonstration of clonal B‐cell populations in marrow would add an extra dimension to B‐LAHS diagnosis.