Non-Hodgkin lymphoma with t(14;18): clonal evolution patterns and cytogenetic-pathologic-clinical correlations

Purpose The pattern and frequency of secondary chromosome abnormalities in t(14; 18)-carrying non-Hodgkin lymphomas ( NHL) were evaluated for differences in relation to histologic NHL subtype and patients' outcome. Methods One hundred and forty-nine NHL patients with t(14; 18) and complete cytogenetic, morphologic, and clinical information were selected. Results One hundred and twelve cases were follicular lymphoma (FL) and 37 were diffuse large B-cell lymphoma (DLBCL). One hundred and forty cases showed secondary aberrations (94%, median = 6.0). The most frequent were losses from chromosome arms 1p and 6q and + 7 (26%). Loss from 1q, + 7, and + 12 were more frequent in DLBCL than in FL. Loss from 1p, Xp, and -16 were more frequent in FL grade 3 than in FL grades 1 and 2. Patients with < 6.0 secondary cytogenetic aberrations had better prognosis than did those with a higher number of aberrations. Trisomy 21 was associated with shorter patient survival. FLIPI score, the number of secondary chromosomal aberrations, and + 21 were all of independent prognostic value in Cox multivariate analysis. FL grade 1-3a patients that had received chemotherapy, showed a higher frequency of i(6p) and loss from 6q. Conclusion Secondary chromosomal aberrations showed some correlation with the morphologic subgroups of t(14; 18)-NHL. Trisomy 21 and the presence of > 6.0 secondary cytogenetic aberrations both correlated with shorter overall survival.