Abstract

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin Lymphoma comprising of greater than 30% of adult non-Hodgkin Lymphomas. DLBCL represents a diverse set of lymphomas, defined as diffuse proliferation of large B lymphoid cells. Numerous cytogenetic studies including karyotypes and fluorescent in situ hybridization (FISH), as well as morphological, biological, clinical, microarray and sequencing technologies have attempted to categorize DLBCL into morphological variants, molecular and immunophenotypic subgroups, as well as distinct disease entities. Despite such efforts, most lymphoma remains undistinguishable and falls into DLBCL, not otherwise specified (DLBCL-NOS). The advent of microarray-based studies (chromosome, RNA, gene expression, etc) has provided a plethora of high-resolution data that could potentially facilitate the finer classification of DLBCL. This review covers the microarray data currently published for DLBCL. We will focus on these types of data; 1) array based CGH; 2) classical CGH; and 3) gene expression profiling studies. The aims of this review were three-fold: (1) to catalog chromosome loci that are present in at least 20% or more of distinct DLBCL subtypes; a detailed list of gains and losses for different subtypes was generated in a table form to illustrate specific chromosome loci affected in selected subtypes; (2) to determine common and distinct copy number alterations among the different subtypes and based on this information, characteristic and similar chromosome loci for the different subtypes were depicted in two separate chromosome ideograms; and, (3) to list re-classified subtypes and those that remained indistinguishable after review of the microarray data. To the best of our knowledge, this is the first effort to compile and review available literatures on microarray analysis data and their practical utility in classifying DLBCL subtypes.Although conventional cytogenetic methods such as Karyotypes and FISH have played a major role in classification schemes of lymphomas, better classification models are clearly needed to further understanding the biology, disease outcome and therapeutic management of DLBCL. In summary, microarray data reviewed here can provide better subtype specific classifications models for DLBCL.

Highlights

  • Certain chromosomal aberrations that were significantly more frequent in a particular Diffuse large B-cell lymphoma (DLBCL) subtype than in the others, and some of these aberrations were associated with clinical outcome

  • Following our review of array based comparative genomic hybridization (aCGH) microarray studies, a number of subsets were re-classified, for example, unique chromosome loci were identified in the following subtypes: primary mediastinal B-cell lymphoma (PMBL), gain at 2p15, 9p24, 9q34, Xp11.4-21, Xq24-26; Large B-cell lymphoma of the bone, gain at 2p16, 6p21 and loss at 15q15-q26; DLBCL of the CNS, loss at 6p21-25,17p12-13; Leg type DLBCL, gain at 2p22, 2p12, 3p21-25, 3q28-29, 9p12-21,16q23,22q11and loss at 4q, 8p11,14q, Xq13-25; CD5+ DLBCL, gain at 13q21-34; Plasmablastic lymphoma, gain at 10p12, 14q32, 16q24,17p12-13 and primary effusion lymphoma with gains at 4q28-35, 8q11.2-23.1, 11p, 17q23-24, 19p13 and loss at 11q24-25

  • Despite these efforts, there is still a number of unclassifiable DLBCL subtypes post-microarray studies. Among these include intravascular LBCL, EBV + DLBCL of the elderly, large B-cell lymphoma arising in HHV8+ multicentric Castleman disease, Lymphomatoid granulomatosis, LBCL with features intermediate between DLBCL and Hodgkin lymphoma (HL) and Pyothorax-associated Lymphoma (PAL)

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Summary

Introduction

Diffuse large B-cell lymphoma (DLBCL) is the most frequent non-Hodgkin lymphoma comprising of greater than 30% of adult non-Hodgkin lymphomas in the West, and an even higher percent in developing countries [1]. Various reasons have been proposed for the various CNA just mentioned above and immuno-chemoresistance These include: faulty p53/INK/ARF functioning caused by 9p21.3 deletions seems to disrupt p53 induced apoptosis, up regulation of various target genes in the nuclear factor kB pathway due to copy number gain of MAPKAPK3 at 3p21.31 leading to nuclear factor kB activation and resulting in high expression of various apoptotic inhibiting genes [28,29,30,31] and copy number gains at 16p13.3 resulting in overexpression of ABCA3, which has been implicated as a likely cause of drug resistance by driving the flow of drugs out of the cell [32]. We explored CNA linked to well-defined WHO subtypes of DLBCL and compared CNA across the various DLBCL subtypes

Review of the literature
Conclusions
Findings
20. Savage KJ
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