HIGH-INCIDENCE OF BCL-6 GENE REARRANGEMENT IN DIFFUSE LARGE B-CELL LYMPHOMA OF PRIMARY GASTRIC ORIGIN

The incidence of BCL-6 gene rearrangement was studied in 39 Hong Kong Chinese patients with diffuse large B-cell lymphoma. The primary site of involvement was nodal in 18 cases and gastric in 21 cases. Clonal B CL-6 gene rearrangement was found in 27% of the patients with primary nodal and 48% with primary gastric lymphoma (p = 0.05). The clinical c haracteristics and treatment outcome of the 22 patients with primary g astric lymphoma were analyzed according to the BCL-6 status. Significa ntly more patients in the germline BCL-6 gene group had advanced stage (ll, III and IV) of disease. Complete remission rate following primar y therapy appeared to be higher for the positive rearrangement group ( 70% versus 36%), but it was not statistically significant. Those with a rearranged BCL-6 gene also appeared to have better survival at 5 yea rs (58% versus 36%) but the difference was also not statistically sign ificant. On the other hand, patients being classified as low risk acco rding to the International Prognostic Index had significantly better s urvival at 5 years (89% versus 9%, p = 0.0001). We concluded that BCL- 6 gene rearrangement was more commonly found in diffuse large B-cell l ymphoma of primary gastric origin than its nodal counterpart and it ma y be playing a more important role in the pathogenesis of gastric larg e B-cell lymphoma. There was a trend that the BCL-6 gene rearrangement was associated with a more favorable outcome in patients with gastric large B-cell lymphoma but the difference was not statistically signif icant. (C) Elsevier Science Inc., 1997.