MULTIPLE BCL-2 IG GENE REARRANGEMENTS IN PERSISTENT POLYCLONAL B-CELLLYMPHOCYTOSIS/

Persistent polyclonal B-cell lymphocytosis is a benign lymphoprolifera tive disorder of unknown aetiology occurring exclusively in women, cha racterized by typical binucleated lymphocytes, polyclonal expansion of B cells and elevated serum IgM. Owing to the role of Bcl-2 oncogene i n inhibition of apoptosis, we have investigated the presence of the bc l-2/Ig gene rearrangement. Bcl-2/Ig gene rearrangement was determined by polymerase chain reaction targeting the usual breakpoint regions of the t(14;18). Bcl-2/Ig gene rearrangement was identified in all six p atients and, more importantly, multiple rearrangements were present in five patients. The frequency of the bcl-2/Ig gene rearrange ment is e stimated to be of one translocation in 1 x 10(2) to 1 x 10(3) peripher al blood mononuclear cells. We conclude that persistent polyclonal B-c ell lymphocytosis is associated with bcl-2/Ig gene rearrangement. Thes e findings are of clinical importance because these patients may be mi sdiagnosed as having a leukaemic expression of non-Hodgkin's lymphoma.