INCIDENCE AND PROGNOSTIC-SIGNIFICANCE OF T(14-18) TRANSLOCATION IN FOLLICLE CENTER CELL LYMPHOMA OF LOW AND HIGH-GRADE - A REPORT FROM SOUTHERN SWEDEN

Background: The t(14;18)(q21;q32) is the most common recurrent genetic defect in follicle center cell lymphoma (FCC). Conflicting reports ex ist in regard to a possible prognostic significance for the translocat ion. Patients and methods: In a single center, 102 patients with eithe r low-grade (n = 50) or high-grade (n = 52) FCC (Kiel classification) and a median follow-up of 82 months were retrospectively studied to de termine survival in relation to t(14;18) as shown by either PCR of the bcl-2 rearrangement in paraffinized tissue or karyotype analysis. Res ults: t(14; 18) was detected in 30 of 50 (60%) low grade FCC and in 12 of 52 (23%) high-grade FCC. The presence of the t(14; 18) was not rel ated to morphologic bone marrow involvement or other clinical paramete rs, but it was related to age: in low-grade FCC, patients with t(14;18 ) were an average of 17 years younger (p = 0.002) than those without t he translocation. In the group with high-grade histology, 30% survived beyond 60 months regardless of t(14;18) status (p = 0.92). Patients w ith low-grade histology and t(14;18) fared better than those without, irrespective of age (p = 0.01). No significant difference in disease-f ree survival related to t(14;18) was found in either low-or high-grade FCC. Conclusions: The incidence of t(14;18) is in accord with that of other European reports. T(14;18) does not define a prognostic subset of high-grade FCC, but is significantly correlated with a better survi val in low-grade FCC. The association of t(14;18) with younger age and indolent lymphoma is perplexing in light of recent findings of an age -related increase in t(14;18) in normal subjects.