F. Stevenson et al., INSIGHT INTO THE ORIGIN AND CLONAL HISTORY OF B-CELL TUMORS AS REVEALED BY ANALYSIS OF IMMUNOGLOBULIN VARIABLE REGION GENES, Immunological reviews, 162, 1998, pp. 247-259
Recombination of V-H, D-H and J(H) genes is a unique first step in nor
mal B-cell development. Subsequent differentiation to a mature plasma
cell is accompanied by further events in the Ig genes, including V-L-J
(L) joining, somatic hypermutation and isotype switching. Chromosomal
changes leading to B-cell rumors can occur at many points in this sequ
ence, and may be partly a consequence of the genetic mobility and muta
bility permitted in order to generate a diverse antibody repertoire. V
genes of neoplastic B cells may reflect the point of maturation reach
ed by the B cell of origin, prior to transformation. Analysis of tumor
s therefore provides useful information on V-gene patterns in normal B
cells, and may add another dimension to classification of B-cell tumo
rs. Transformation may also preserve cell populations normally destine
d to die by apoptosis. Tumor cells arrested in the site where somatic
hypermutation and isotype switch are occurring can still be subject to
these processes, and could be influenced by persisting antigen. Howev
er, mutation is silenced at the point of exit to the periphery, leadin
g to fixed mutational patterns in rumors of mature B cells. V-gene ana
lysis provides an invaluable tool for understanding the genesis of neo
plastic change. It also has a clear clinical relevance in tracking tum
or cells, measuring residual disease, and finally in offering the oppo
rtunity of developing vaccines for treatment.