PROGNOSTIC-SIGNIFICANCE OF IMMUNOGLOBULIN HEAVY-CHAIN GENE REARRANGEMENT IN PATIENTS WITH ACUTE MYELOGENOUS LEUKEMIA

Recently the immunoglobulin heavy chain (IgH) gene rearrangement in B cell malignancies has been analyzed. Clonality can be determined using the polymerase chain reaction (PCR). Little attention, however, has b een given to the relationship between prognosis and IgH gene rearrange ment in patients with acute myelogenous leukemia (AML). In this study, we examined IgH gene rearrangement in 35 untreated AML patients by PC R. PCR was performed using consensus heavy chain complimentarity-deter mining region (CDR)-3 primers. Clonal IgH gene rearrangement was detec ted in 14 patients (40%). Four of five patients (80%) who were positiv e for B cell markers had clonal IgH gene rearrangement. Ten of 30 B ce ll antigen-negative patients (33%) also showed IgH rearrangement. All patients were treated with a daunorubicin-based regimen, resulting in complete remission for 29 patients (83%). Sixty-four percent of those with IgH rearrangement and 95% of those without rearrangement had comp lete remission. Overall survival of IgH-PCR positive and negative pati ents at 25 months was 29 and 88%, respectively. IgH-PCR positivity may be a poor prognostic factor in AML.